摘要
目的观察塞来昔布联合帕瑞昔布钠术前预处理对类风湿关节炎(RA)全膝关节置换术(TKA)术后镇痛效果及炎性因子的影响。方法选取行TKA的RA患者83例,随机分为超前镇痛组(41例)和对照组(42例),超前镇痛组术前24、12 h给予塞来昔布,术前30 min给予帕瑞昔布钠;对照组给予安慰剂,2组患者均给予硬膜外麻醉,术后给予自控硬膜外镇痛(PCEA)。记录不同时间点、时间段2组患者的视觉模拟评分法(VAS)评分、术后按压镇痛泵次数及口服氨酚羟考酮补救止痛剂量;记录不同时间点2组患者的白细胞介素-6(IL-6)及C反应蛋白(CRP)水平。结果超前镇痛组术后6、12 h VAS评分显著低于对照组(P<0.05);超前镇痛组术后PCEA按压次数显著低于对照组(P<0.05);超前镇痛组术后24 h内给予补救止痛药剂量显著低于对照组(P<0.05)。术后6、12 h超前镇痛组IL-6和CRP水平显著低于对照组(P<0.05)。结论对于累及膝关节的RA患者行TKA,术前行塞来昔布联合帕瑞昔布钠预处理能明显增强术后24 h内的镇痛效果,减少镇痛药的用量,并可显著控制RA患者术后的炎性反应。
Objective To observe the effect of preoperative application of celecoxib combined with parecoxib sodium on postoperative analgesia and inflammatory factors after total knee arthroplasty(TKA)in rheumatoid arthritis(RA).Methods 83 patients with RA for TKA patients were randomly divided into preemptive analgesia group(41 cases)and control group(42 cases).The preemptive analgesia group were treated with celecoxib at 24 hours and 12 hours before operation and parecoxib sodium at 30 minutes before operation.The control group were treated with placebo.Both groups were treated through epidural anesthesia and postoperative analgesia pump with patient controlled epidural analgesia(PCEA).At different time points and periods,the visual analogue scale(VAS)score,postoperative analgesia pump compression times and oral paracetamol and oxycodone remedial analgesic dose were recorded.The levels of interleukin-6(IL-6)and C-reaction protein(CRP)were measured.Results VAS scores of preemptive analgesia group were significantly lower than those of control group at 6 hours and 12 hours after surgery(P<0.05).The number of PCEA compression in preemptive analgesia group was significantly lower than that in control group(P<0.05).Within 24 hours after operation,the dose of remedial analgesic in preemptive analgesia group was significantly lower than that in control group(P<0.05).The levels of IL-6 and CRP in preemptive analgesia group were significantly lower than those in control group at 6 hours and 12 hours after operation(P<0.05).Conclusion For RA patients with knee joint involvement undergoing TKA,preoperative celecoxib combined with parecoxib sodium pretreatment can significantly enhance the analgesic effect within 24 hours and reduce the dosage of analgesics,which can significantly control the postoperative inflammatory response in patients with RA.
作者
裴海波
张富军
张浩
苏龙
陈士军
胡筱娟
PEI Haibo;ZHANG Fujun;ZHANG Hao;SU Long;CHEN Shijun;HU Xiaojuan(Department of Orthopaedics,Xidian Group Hospital,Xi′an 710077,China;Department of Neurosurgery,Xidian Group Hospital,Xi′an 710077,China;Department of Endocrinology,Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi′an 710077,China)
出处
《西北药学杂志》
2021年第4期642-646,共5页
Northwest Pharmaceutical Journal
基金
陕西省重点研发计划项目(编号:2017SF-333)。
