术中关节周围鸡尾酒注射在骨性关节炎患者初次全膝关节置换术后镇痛中的应用

目的探讨术中关节周围注射混合镇痛药物(鸡尾酒)在膝关节骨性关节炎初次全膝关节表面置换术后镇痛中的疗效。方法选取我院关节外科2017年1月～2017年12月收治的60例行单侧表面全膝关节置换术(TKA)的膝关节骨性关节炎患者为研究对象,按照是否注射鸡尾酒分为干预组、对照组,比较两组患者术后48 h、1周、1月、3月、6月的疼痛视觉模拟(VAS)评分、膝关节活动度(ROM)、美国膝关节协会评分(KSS评分)、患者满意度及不良反应、切口并发症。结果干预组术后48 h、1周的VAS评分低于对照组(P0.05),干预组术后48 h、1周ROM大于对照组(P0.05),干预组术后48 h、1周KSS评分高于对照组(P0.05),干预组术后48 h、1周满意度高于对照组(P0.05)。未发现切口并发症。以上指标在术后1月、3月、6月均无统计学差异(P0.05)。结论术中鸡尾酒注射在TKA术后早期镇痛疗效确切,可改善早期功能,改善住院体验,提高患者满意度,促进患者早期康复。

Pain control of intraoperative periarticular multimodal injection in total knee arthroplasty for patients of osteoarthritis

［Abstract］ Objective This study aims to explore the effectiveness of pain control of intraoperative periarticular multimodal injection in total knee arthroplasty for patients of osteoarthritis. Methods Sixty patients of knee osteoarthritis undergoing unilateral primary total knee arthroplasty were divided into injection group and control group. The patients were observed and followed at 48 hours, 1 week, one month, three months, and six months postoperatively. The Visual Analogue Scale（VAS）, Range of motion （ROM）、American Knee Society Score （KSS）, patient satisfaction, side effects and wound complications were recorded and statistically analyzed. Results There was a lower VAS in the injection group 48hours and one week after TKA（P<0.05）. A larger range of motion, a higher KSS and satisfaction rate were observed 48hours and one week postoperatively（P<0.05）. None of the indexes above were found statistically significant at one month, three months or six months postoperatively. No wound complication occurred. Conclusion Periarticular multimodal injection is effective in pain control after TKA in the early period, and it brings early function recovery, better inpatient experience, higher satisfaction rate, and faster rehabilitation eventually.