摘要
目的探讨老年患者全膝关节置换术后镇痛的有效方式,为全膝关节置换术后镇痛临床实践提供参考。方法选取2016-01/2017-08月收治的老年全膝关节置换术患者96例为研究对象,采用随机数字表法将患者随机分为研究组和对照组,各48例。研究组给予关节周围注射镇痛药物联合静脉自控镇痛(patient-controlled intravenous analgesia,PCIA),对照组仅给予PCIA。对两组患者实施不同镇痛方案的术后首次下床时间、 PCIA首次自控时间和术后镇痛泵按压次数以及患者术后各时间点静息及运动视觉模拟评分(visual analogue scale,VAS)结果进行观察比较。结果研究组患者的术后首次下床时间明显早于对照组(P<0.01),研究组患者的PCIA首次自控时间明显晚于对照组(P<0.01),同时研究组患者的术后镇痛泵按压次数明显少于对照组(P<0.01)。术后8、12、24、48 h时,研究组患者静息及运动VAS评分均明显低于对照组(P<0.01或0.05)。结论在老年患者全膝关节置换术后镇痛实践中采用关节周围注射镇痛药物与PCIA联合应用的镇痛方式效果较好。
Objective To investigate the effective way of analgesia after total knee arthroplasty in elderly patients,and provide reference for the clinical practice of analgesia after total knee arthroplasty.Methods A total of 96 patients with total knee arthroplasty from January 2016 to August 2017 were chosen as the research object and randomly divided into study group and control group by random number table method,each group with 48 patients.The study group received postoperative periarticular injection analgesia combined with patient-controlled intravenous analgesia(PCIA).The control group received postoperative PCIA only.The time for first out-of-bed activity,PCIA first self-control time,pressing times of analgesic pump,the resting and exercise visual analogue scale(VAS) scores at different time points were observed and compared between two groups.Results The postoperative time for first out-of-bed activity of study group was significantly earlier than that of control group(P<0.01).The PCIA first self-control time of study group was significantly later than that of control group,and the pressing times of analgesic pump of study group were significantly less than those of control group(all P<0.01).At 8,12,24 and 48 hours after operation,the resting and exercise VAS scores of study group were significantly lower than those of control group(P<0.01 or 0.05).Conclusion The postoperative periarticular injection analgesia combined with PCIA has better analgesic effect for patients with total knee arthroplasty.
作者
甘国胜
陈晓龙
阮剑辉
胡光俊
刘方
GAN Guosheng;CHEN Xiaolong;RUAN Jianhui;HU Guangjun;LIU Fang(Department of Anesthesiology,the General Hospital of Central Theatre Command,Wuhan Hubei 430070,China)
出处
《华南国防医学杂志》
CAS
2019年第2期111-113,共3页
Military Medical Journal of South China
关键词
关节周围注射
静脉自控镇痛
全膝关节置换术
镇痛效果
Periarticular injection
Patient-controlled intravenous analgesia
Total knee arthroplasty
Analgesic effect
