中国组织工程研究2017，Vol.21Issue(31)：4945-4950,6.DOI:10.3969/j.issn.2095-4344.2017.31.005
两种镇痛方法对全膝关节置换围置换期应激反应及血管活性物质的影响
Effects of two analgesia methods on the stress response and hemodynamics during total knee arthroplasty
摘要
Abstract
BACKGROUND: Pain relief in patients with total knee arthroplasty has always been an important problem, and searching for a safe and effective analgesic method is an issue of concern.OBJECTIVE: To compare the effects of patient controlled nerve femoral analgesia and patient controlled epidural analgesia on the perioperative stress response and hemodynamics in patients with total knee arthroplasty.METHODS: Sixty patients undergoing unilateral total knee arthroplasty admitted in the First Affiliated Hospital of Hainan Medical University from August 2012 to January 2016 were selected and equally divided into observation and control groups according to the order of admission. The total knee arthroplasty was completed by the senior doctors using operation criteria. The patient controlled epidural analgesia analgesia was used in the control group, while the observation group received the patient controlled nerve femoral analgesia analgesia. The prognosis, perioperative stress response and hemodynamic changes were observed.RESULTS AND CONCLUSION: (1) The Visual Analogue Scale scores at postoperative 4, 24 and 48 hours in the observation group were significantly lower than those in the control group (P < 0.05). (2) The serum level of 5-hydroxytryptamine at postoperative 24 and 48 hours in the observation group was significantly lower than that in the control group (P < 0.05). (3) The American Knee Society Knee Score scores at baseline showed no significant difference between two groups, and then appeared to be on a significant rise postoperatively (P < 0.05), while the scores at postoperative 1 and 3 months in the observation group were significantly higher than those in the control group (P < 0.05).(4) The incidence of respiratory depression, urinary retention, atelectasis, skin itching, nausea and vomiting at postoperative 3 months in the observation group was significantly less than that in the control group (P < 0.05). (5) These results manifest that compared with the patient controlled epidural analgesia, the patient controlled nerve femoral analgesia in total knee arthroplasty can alleviate the stress response to pain and reduce the expression of 5-hydroxytryptamine and the incidence of complications, further promoting the recovery of joint function.关键词
骨科植入物/人工假体/全膝关节置换/应激反应/血管活性物质/股神经阻滞自控镇痛/自控硬膜外镇痛/海南省自然科学基金分类
医药卫生引用本文复制引用
李媛,谢海,周期,张娇..两种镇痛方法对全膝关节置换围置换期应激反应及血管活性物质的影响[J].中国组织工程研究,2017,21(31):4945-4950,6.基金项目
海南省自然科学基金项目(813189):炎症因子调节围手术期老年病人血糖代谢对术后认知功能的影响 the Natural Science Foundation of Hainan Province, No. 813189 （813189）
