摘要
目的对比研究2种不同给药途径镇痛方式在全膝关节置换(TKA)术后的镇痛效果。方法由同组医师完成的治疗骨性关节炎的TKA 40例(40膝),采用随机的方法分为术后静脉镇痛泵给药镇痛组(A组)和术后持续切口镇痛装置给药镇痛组(B组),每组各20例。A组采用的药物为曲马多注射液和生理盐水混合,B组采用的药物为盐酸丁哌卡因注射液和生理盐水混合。比较2组在术后围手术期不同时间点疼痛视觉模拟评分(VAS),辅助口服镇痛药物塞来昔布使用量及不良事件发生率。结果 2组术后围手术期VAS评分不同时间点比较无统计学意义(P>0.05),辅助口服镇痛药物塞来昔布使用量及不良事件发生率方面B组明显优于A组(P<0.05)。结论 TKA术后采用术后持续切口镇痛装置给药镇痛明显优于传统静脉泵给药途径,可以明显降低辅助口服镇痛药物用量和不良事件发生率,获得了良好的镇痛疗效,镇痛的靶向性更强、使用更安全。
Objective To compare the analgesic effect of two different drug-delivery ways after total knee arthroplasty（TKA）. Methods In a series of 40 cases（40 knees） of osteoarthritis（OA）, all patients who underwent total knee arthroplasty by the same surgeon team, were randomly divided into two groups, each group with 20 cases（20 knees）. Intravenous analgesia pump group （group A） was used by tramadol injection and physiological saline mixed. And local analgesia device group （group B） was used by bupivacaine hydroehloride injection and physiological saline mixed. The postoperative visual analog seores（VAS） of pain at different time points, auxiliary oral analgesic drug celecoxib usage and the incidence of adverse events were observed and compared. Results There was no significant statistic difference between two groups in different time points＇ VAS （P〉0.05）. But the auxiliary oral analgesic drug celeeoxlb usage and the incidence of adverse events of group B were better than group A （P 〈0.05）. Conclusion Local analgesia device is better than intravenous analgesia pump in analgesic way after TKA. It can significantly reduce the auxiliary oral analgesic drug dose and incidence of adverse events. Local analgesia device has stronger targeting property and security.
出处
《中国骨与关节损伤杂志》
2014年第4期344-346,共3页
Chinese Journal of Bone and Joint Injury
