摘要
目的观察塞来昔布联合曲马多对膝关节表面置换术的超前镇痛疗效。方法将行膝关节表面置换术的90例随机分为A、B、C三组,术前2 d至禁食前分别口服盐酸曲马多缓释片50 mg、塞来昔布胶囊200 mg、塞来昔布胶囊100 mg+盐酸曲马多缓释片25 mg,术后6 h分别口服盐酸曲马多缓释片50 mg、塞来昔布胶囊200 mg、塞来昔布胶囊100 mg+盐酸曲马多缓释片25 mg,术后2 d分别口服盐酸曲马多缓释片50 mg/12 h、塞来昔布胶囊200 mg q12 h、塞来昔布胶囊100 mg+盐酸曲马多缓释片25 mg/12 h;三组患者均于术后麻醉消失后行硬膜外镇痛(PCEA),观察比较三组患者术后8 h、24 h、36 h、48 h静息状态下疼痛和术后3晚睡眠的视觉模拟评分法(VAS)评分、PCEA首次按压时间及术后48 h内按压次数、患者疼痛满意度、药物不良反应。结果 C组患者镇痛疗效、睡眠质量、疼痛满意度均显著优于A组、B组(P<0.05),C组显著地提升镇痛效果。三组术后不良反应未见显著差异(P>0.05)。结论围术期联合应用塞来昔布和曲马多可有效实现膝关节表面置换术的超前镇痛。
Objective To observe the efficacy of celecoxib combined tramadol in treatment of preemptive analgesia for total knee replacement surgery .Methods 90 patients undergoing total knee arthroplasty were randomly divided into three groups ,namely group A,group B,group C,before two days to fast oral tramadol hydrochloride sustained-release tablets 50 mg,celecoxib capsules 200 mg,plug celecoxib capsules 100 mg ＋tramadol hydrochloride sustained-release tablets 25 mg,respectively.After six hours of oral or gastric infusion of tramadol hydrochloride sustained-release tablets 50 mg, celecoxib capsules 200 mg, celecoxib capsules tramadol hydrochloride 100 mg ＋25 mg sustained-release tablets and after two days be tramadol hydrochloride sustained-release tablets 50 mg/12 h oral celecoxib capsules 200 mg/12 h oral celecoxib capsules 100 mg ＋tramadol hydrochloride sustained-release tablets 25 mg/12 h orally,three groups of patients disappeared underwent epidural analgesia （PCEA） in the postoperative anesthesia.Three groups of patients were observed and compared after 8 h,24 h,36 h,48 h resting under after three nights of sleep and pain VAS score , PCEA first press time and 48 h after pressing the number of patient satisfaction with pain ,adverse drug reactions .Results The patients in group C of analgesic efficacy,quality of sleep,pain,satisfaction were significantly better than in group A ,group B （P〈0.05）.The group C significantly enhanced the analgesic effect .Three groups had no significant difference in adverse events （P〉0.05）.Conclu-sion The combination of perioperative celecoxib and tramadol preemptive analgesia can effectively achieve full knee .
出处
《东南国防医药》
2014年第4期360-362,366,共4页
Military Medical Journal of Southeast China
