双氯芬酸钠栓用于老年全膝关节置换术围术期镇痛的临床研究

目的探讨双氯芬酸钠栓对老年全膝关节置换术(TKA)围术期镇痛疗效。方法将92例TKA手术患者分成2组,对照组予美洛昔康分散片口服7.5 mg/次,2次/d,术后静脉镇痛泵镇痛,研究组在对照组基础上加用双氯芬酸钠栓50 mg纳肛,观察不同镇痛模式在术后24、48 h、术后3 d、1周、2周疼痛视觉模拟评分(VAS)、膝关节活动度和不良反应变化情况。结果 2组术后VAS评分均不断下降,关节活动度均不断升高,研究组术后24、48 h、术后3 d、1周、2周在静息和活动VAS评分上均显著低于对照组(P0.05),而在主动和被动关节活动度上均显著高于对照组(P0.05);2组恶心呕吐、尿潴留、呼吸抑制、头晕头痛等不良反应发生率比较无显著差异(P0.05)。结论双氯芬酸钠栓辅助治疗能提高TKA围术期镇痛效果,提高关节活动度,且不良反应低。

Diclofenac sodium suppository for perioperative analgesia in elderly patients with total knee arthroplasty

Objective To explore effect of diclofenac sodium suppository on perioperative analgesia efficacy of senile total knee arthroplasty (TKA).Methods A total of 92 TKA patients were divided into 2 groups according to the date of admission,control group was treated with Meloxicam Dispersible Tablets for 7.5 mg every time,twice a day and intravenous analgesia pump,the research group used diclofenac sodium suppository for 50 mg in anus based on the control group.Pain Visual analogue scale (VAS),knee joint activity and adverse changes of different modes of analgesia in postoperative 24,48 h,3 d,1 week,and 2 weeks were observed.Results Postoperative VAS score of two groups was decreased,joint activities were increased,VAS scores in the study group in postoperative 24,48 h,3 d,1 week,2 weeks were significantly lower than the control group (P ＜0.05),and active and passive joints on the activity were significantly higher than control group (P ＜0.05);Incidence rate of adverse reaction,nausea and vomiting,urinary retention,respiratory depression,dizziness and headache in two groups showed no significant difference (P ＞ 0.05).Conclusion Adjuvant therapy of diclofenac sodium suppository can improve the perioperative analgesic effect,improve joint mobility,and lower adverse reactions.