全膝关节置换术中关节周围注射混合镇痛液的疗效观察

目的探讨全膝关节置换（TKA）中向关节周围注射混合镇痛液的疗效。方法将本组48例行TKA的患者随机分成两组，24例行术中关节周围注射混合镇痛药，另24例不注射任何药物，两组均在术后48h内使用患者白控镇痛（PCA），术后于不同时间点分别记录PCA的用量，采用视觉模拟疼痛量表（VAS）评估患者疼痛程度。结果注射组在术后各时段PCA使用量和48h内PCA使用总量比对照组明显少（P〈0．05）。与对照组相比，注射组术后在第2、6、10、12、24、36、48小时的静息状态VAS评分和术后24、36、48小时活动状态下的VAS评分明显低（P〈0．05）；两组患者在术后第3、7、15、42天静息和活动状态下的VAS评分间的差异无统计学意义（P〉0．05）。结论TKA术中向关节周围注射混合镇痛液在术后早期可有效缓解疼痛并减少阿片类药物的用量。

Observation of the efficacy of periarticular multimodal analgesic drugs injection in total knee arthroplasty

Objective To study the efficacy of periarticular multimodal analgesic drugs injection in total knee arthroplasty. Methods 48 patients undergoing total knee arthroplasty were randomized to two groups, 24 patients received periarticular intraoperative injection of muhimodal analgesic drugs, and others without any drug, s injection were as control. All patients received patient-controlled analgesia for 48 hours after surgery. Pain and satisfaction of patients were evaluated with a visual analog scale postoperatively. The consumption of patient-controlled analgesia was also recorded at different time-points. Results The patients of trial group used significantly less patient-controlled analgesia at all the time-points and in the aggregate consumption. Compared to control group, they had lower visual analog scores for pain at rest at time-polnts of 2, 6, 10, 12, 24, 36, 48 h, and at movement at time-points of 24, 36, 48 h. At time-points of 3, 7, 15, 42 d, the VAS scores between two groups have no statistical difference. Conclusions Periarticular injection of multimodal analgesic drugs in total knee arthroplasty can significantly reduce the postoperative pain of patients and the nacrotic consumption of patient-controlled analgesia.