不同剂量氨酚羟考酮对膝关节置换术后镇痛效果的研究

目的观察口服氨酚羟考酮片在膝关节置换术后患者中的镇痛疗效和安全性,选择最佳的给药剂量。方法选择行单侧全膝关节置换患者50例,随机分为氨酚羟考酮10mg组和5mg组,均为Q8H给药,同时使用股神经阻滞（0.2%罗哌卡因）,两组患者均维持镇痛5 d。术后记录静息痛、康复锻炼疼痛最重时、康复锻炼结束时疼痛评分、膝关节被动活动度、膝关节主动活动度,记录功能活动时疼痛：下床、行走、即刻松拐疼痛评分,以及药物相关的并发症。结果氨酚羟考酮10mg组患者在术后1 d、3 d的静息痛VAS评分及膝关节主动活动优于5mg组,不良反应发生率10mg组为26.7%,5mg组为10%。结论氨酚羟考酮用于全膝关节置换术后康复镇痛效果良好,建议在术后早期（1～3天）使用10mg,Q8H给药,以缓解患者的静息痛、锻炼痛,之后可以减药量为5mg,Q8H,也可以达到满意的功能表现,同时减少药物的副作用。

Comparison of two different dosages of oxycodone acetaminophen used after total knee arthroplasty

Objective To observe the analgesic efficacy and safety of oxycodone acetaminophen tablets after total knee arthroplasty.Methods Fifty patients undergoing unilateral TKA surgery were randomly divided into two groups. The patients took oxycodone acetaminophen tablets lOmg Q8H or 5 mg Q8H after TKA.We also used continuous femoral nerve block.Measures of interest included pain ratings as determined with a visual-analog scale,changes in the range of motion of the knee,VAS scores during rest,Worst during physical therapy,transfers,walking,immediate-release climb.Results The patients who received lOmg tablets reported significantly less pain as well as significantly greater range of motion of the knee than 5mg during 1～3 days.Conclusion Use of oxycodone acetaminophen during rehabilitation following total knee arthroplasty leads to improved pain control,more rapid functional recovery.