全髋关节置换围术期应用塞来昔布超前镇痛的疗效评估

目的观察塞来昔布对于髋关节置换的超前镇痛作用,及其减少其他镇痛药物用量和不良反应的效果。方法 40例股骨头坏死行髋关节置换患者,随机分为观察组(手术禁食前首次给药400 mg,手术后6 h再次给药200 mg,术后2 d,塞来昔布200 mg,2次/d);对照组(术前不给药)。两组均于术后麻醉药物作用消失后使用硬膜外镇痛(PCEA),维持手术后48 h。分别于入院时,麻醉前、术后0 h、2 h、4 h6、h、12 h、24 h、48 h进行可视痛觉评分(VAS),记录镇痛药物用量、不良反应。结果实验组患者围术期VAS评分低于对照组(P<0.05),围术期其他镇痛药物用量及药物不良反应明显低于对照组(P<0.05)。结论围术期使用塞来昔布能有解全髋关节置换手术后疼痛,明显减少术后镇痛泵及阿片类药物的使用量,且副作用较小,对于术后髋关节早期活动及功能锻炼有非常积极的意义,因而一定程度上提高了髋关节置换患者术后功能恢复。

The effect of Celecoxib preemptive analgesia on total hip replacement

Objective To investigate Celecoxib′s preemptive analgesia effect on total hip replacement(THR),and to find whether it has the effect of reducing the dosage and side effects of anaesthetic drugs.Methods Forty THR patients were randomly divided into two groups with equal members.The preoperative analgesia group(Celecoxib oral 400 mg preoperative,200 mg 6 h after operation,the after 2 days 200 mg oral Bid) and the contrast group(No Celecoxib used before operation).PECA were used 48 h postoperatively on all the patients of the 2 groups.VAS was recorded during perioperative period.The dosage and side effects of anaesthetic drugs were also observed.Results Celecoxib can reduce the VAS of THR,and reduce the use of other anaesthetic drugs and side effects(P<0.05).Conclusion The use of Celecoxib in the perioperative period can alleviate pains after surgery and reduce the intake of anaesthetic drugs with less side effects.It is very important to help hip replacement patients to have early functional exercise.Thus it helps the functional recovery.