多模式镇痛在人工髋关节置换术中的应用效果

摘要
图/表
参考文献(15)
相关文章 (15)

全文: PDF (0 KB) HTML (34 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨多模式镇痛在人工髋关节置换术中的应用效果。方法选取2015年1～12月我院收治的110例行人工髋关节置换术患者为研究对象，采用随机数字表法分为观察组和对照组，各55例。对照组术中行关节周围注射盐酸罗哌卡因，术后静脉自控镇痛泵镇痛；观察组术中静脉注射帕瑞昔布及盐酸罗哌卡因，术后则给予帕瑞昔布钠、盐酸曲马多、塞来昔布进行镇痛，采用视觉模拟评分法（VAS）进行疼痛程度评价，对比两组患者术后返回病房时，术后6、12、24、48、72 h的疼痛情况、不良反应情况及康复运动依从性。结果观察组患者在术后返回病房时，术后6、12、24、48、72 h的VAS评分均显著低于对照组，差异有统计学意义（P＜0.05）。观察组患者术后发生恶心呕吐6例，头晕头痛2例，不良反应发生率为14.5%，对照组术后发生恶心呕吐7例，头晕头痛1例，尿潴留1例，不良反应发生率为16.4%，两组不良反应发生率比较，差异无统计学意义（P＞0.05）。观察组患者术后康复运动依从率为96.4%，显著高于对照组的83.6%，差异有统计学意义（P＜0.05）。结论对人工髋关节置换术患者实施多模式镇痛能够有效地减轻患者术后的疼痛程度，安全性较好，患者可更好地在术后进行康复运动，值得临床上推广应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	陈希聪
	周观明
	刘少华
	彭健泓

关键词 ：人工髋关节置换术, 多模式镇痛, 康复运动, 不良反应

Abstract：ObjectiveTo investigate the effect of multimodal analgesia in artificial hip replacement.Methods110 patients with artificial hip replacement in our hospital from January to December 2015 were selected as research objects and divided into observation group and control group by random number table method,55 cases in each group.Patients in the control group were given with intraoperative periarticular injection of Ropivacaine hydrochloride and postoperative self controlled intravenous analgesia pump,patients in the observation group were given with vein injection of Parecoxib and Ropivacaine hydrochloride,postoperative Parecoxib sodium,Tramadol hydrochloride and Celecoxib analgesia analgesia,pain was evaluated by visual analogue scale (VAS),pain,adverse reaction and rehabilitation exercise compliance returning to the ward,6,12,24,48,72 h after operation between two groups were compared.ResultsVAS scores returning to the ward,6,12,24,48,72 h after operation in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P＜0.05).Postoperative nausea and vomiting in the observation group occurred in 6 cases,dizziness and headache of 2 cases,the adverse reaction rate was 14.5%,postoperative nausea and vomiting in the control group occurred in 7 cases,headache in 1 case,1 case of urinary retention,the adverse reaction rate was 16.4%,there was no significant difference between two groups(P＞0.05).Postoperative rehabilitation exercise compliance rate in the observation group was 96.4%,which was significantly higher than that in the control group (83.6%),and the difference was statistically significant(P＜0.05).ConclusionThe implementation of multimodal analgesia can effectively reduce the pain degree of patients with artificial hip replacement after operation,has good safety,patients can implement better rehabilitation exercise after operation,which is worthy of promotion in clinical application.

Key words： Artificial hip replacement Multimodal analgesia Rehabilitation exercise Adverse reactions

作者简介: 陈希聪（1979-），男，硕士，副主任医师，主要从事骨外科学方面的研究

引用本文:

陈希聪；周观明；刘少华；彭健泓. 多模式镇痛在人工髋关节置换术中的应用效果[J]. 中国当代医药, 2017, 24(6): 44-46.
CHEN Xi-cong；ZHOU Guan-ming；LIU Shao-hua；PENG Jian-hong. Application effect of multimodal analgesia in artificial hip replacement. 中国当代医药, 2017, 24(6): 44-46.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I6/44

[1]	Wang SY，Olson-Kellogg B，Shamliyan TA，et al.Physical therapy interventions for knee pain secondary to osteoarthritis：a systematic review[J].Ann Intern Med，2012，157（9）：632-644.
[2]	Brander VA，Stulberg SD，Adams AD，et al.Predicting total knee replacement pain：a prospective，observational study[J]. Clin Orthop Relat Res，2013，416（4）：27-36.
[3]	Reuben SS，Buvanendran A.Preventing the development of chronic pain after orthopaedic surgery with preventive multimodal analgesic techniques[J].J Bone Joint Surg（Am），2012，89（6）：1343-1358.
[4]	Turner NM，Van de Leemput AJ，Draaisma JM，et al.Validity of the visual analogue scale as an instrument to measure self efficacy in resuscitation skills[J].Med Educ，2013，42（5）：503-511.
[5]	Giuffre M，Asci J，Arnstein P，et al.Postoperative joint replacement pain：deseription and opioid requirement[J].J Post Anesth Nurs，2011，6（4）：239-245.
[6]	Woolf CJ，Chong MS.Preemptive analgesia--treating postoperative pain by preventing the establishment of central sensitization[J].Anesth Analg，2013，77（2）：362-379.
[7]	Igor Kissin.Preemptive analgesia[J].Anethesiology，2014，84（5）：1015-1018.
[8]	吴祥，徐委，章飞，等.帕瑞昔布在腰椎退行性疾病围手术期镇痛中的应用[J].中国骨与关节损伤杂志，2013，28（3）：256-257.
[9]	周嵘，钱齐荣.全膝关节置换术围手术期镇痛的研究现状[J].中国骨与关节损伤杂志，2012，27（8）：773-774.
[10]	Lewis C，Gunta K，Mitchell K，et al.Effectiveness of multimodal pain management protocol in total knee arthroplasty patients[J].Orthop Nurs，2012，31（3）：153-159.
[11]	张俊，蒋垚，邵俊杰，等.人工全膝关节置换术中关节周围注射镇痛药物和术后持续性冷冻压迫的疗效分析[J].中国骨与关节损伤杂志，2008，23（3）：205-207.
[12]	殷文明.自控静脉镇痛泵用于混合痔术后镇痛的临床观察[J].现代中西医结合杂志，2011，20（2）：214-215.
[13]	中华医学会麻醉学分会.成人术后疼痛处理专家共识[J].临床麻醉学杂志，2010，3（26）：190-195.
[14]	张会东，于松杨，王晓东，等.多模式镇痛的临床研究现状[J].医学综述，2011，4，17（7）：1072-1075.
[15]	Kemal SO，Ahin S，Apan A.Comparison of tramadol，tramadolmetamizol and tramadol-lornoxicam administered by intravenous PCA in management of postoperative pain[J]. Ari，2007，19（4）：24-31.