全髋关节置换后局部关节注射鸡尾酒与静脉注射帕瑞昔布镇痛的对比

背景：关节内鸡尾酒注射阵痛是一种新颖的全髋关节置换后镇痛方法，可有效控制置换后疼痛，减少不良反应。目的：比较全髋关节置换后关节内鸡尾酒式混合剂注射与静脉注射帕瑞昔布的效果和安全性。方法：将60例行单侧全髋关节置换的患者进行随机分配：治疗组行关节内鸡尾酒式镇痛混合剂（包括吗啡、布比卡因、复方倍他米松）注射，对照组予帕瑞昔布静脉注射做对照。所有患者置换后24h接受口服盐酸曲马多镇痛，比较两组患者置换后髋关节静息和活动目测类比疼痛评分，止痛药使用情况，髋关节活动度以及置换后并发症。结果与结论：采用关节内鸡尾酒式镇痛混合剂注射后，可以显著减少置换后镇痛药使用量。在目测类比评分的比较上，治疗组静息痛评分在置换后12，24，48h显著小于对照组（P〈0．05），治疗组活动痛评分在置换后24，36h显著小于对照组（P〈0．05）。在总并发症监测上，两组间差异无显著性意义（P〉0．05）。结果可见关节内鸡尾酒式镇痛混合剂注射有助于减少置换后麻醉镇痛剂使用量，减轻置换后早期疼痛，有助于患者的早期康复，且没有明显的不良反应。

Analgesic effects of intraarticular cocktail versus intravenous parecoxib injection after total hip arthroplasty

BACKGROUND： Intraarticular cocktail analgesic injection is a popular postoperative analgesia method and can effectively control postoperative pain and relieve side effects after total hip arthroplasty. OBJECTIVE： To compare and assess the effectiveness and safety of intraarticular analgesic injection or intravenous injection .of parecoxib after total hip arthroplasty. METHODS： A total of 60 patients undergoing total hip arthroplasty were randomly assigned to： treatment group （Jntraarticular cocktail analgesic injection with morphine, bupJvacaJne, and compound betamethasone）, and control group （intravenous injection of parecoxib）. All patients received tramadol hydrochloride at 24 hours after replacement. Analgesic consumption, visual analog scale at rest and during activity, range of motion, and postoperative complication of patients in each group were recorded. RESULTS AND CONCLUSION： Intraarticular cocktail analgesic injection significantly reduced analgesic consumption. When comparing visual analog scale scores, rest pain ＇scores were significantly less in the treatment group at 12, 24 and 48 hours after replacement than that in the control group （P 〈 0.05）. Scores on range of motion were significantly less in the treatment group at 24 and 36 hours than that in the control group （P 〈 0.05）. No significant differences in total complications were detectable between the treatment and control groups （P 〉 0.05）. Results suggested that intraarticular cocktail analgesic injection lessened analgesic consumption after replacement, relieved early pain after replacement, and contributed to early rehabilitation of patJents. Moreover, no significant adverse reactions were visible.