人工全膝关节置换术后多种模式联合镇痛对早期术后功能康复的影响

目的探讨多种模式联合镇痛对人工全膝关节置换患者早期减轻疼痛和功能康复的影响。方法 2011年至2013年采取人工全膝关节置换患者50例,按照治疗方式分为治疗组25例和对照组25例。治疗组患者采用多模式联合镇痛方案,对照组患者术后给予常规自控静脉镇痛(PCIA)。术后记录并比较静息状态下视觉模拟疼痛评分(visual analogue score,VAS)、Rameasay评分、膝关节活动度(range of motion,ROM)、副反应和杜冷丁使用频次。结果治疗组早期患肢疼痛VAS显著低于对照组(P0.05);治疗组和对照组Rameasay评分无显著性差异(P0.05);治疗组患膝关节活动度ROM显著大于对照组(P0.05);发生副反应和使用杜冷丁的频次小于对照组。结论人工全膝关节置换术后采用多模式镇痛可以减轻早期患肢疼痛,提高关节活动度,可降低副反应发生率和杜冷丁使用率。

Results of multimodal analgesia in pain relief and rehabilitation after total knee replacement

Objective To observe the early efficacy of postoperative muhimodal analgesia in pain relief and rehabilitation after total knee replacement. Methods From 2011 to 2013 ,a total of 50 patients undergoing unilateral knee arthroplasty were randomly assigned to be treated with muhimodal analgesia （treatment group,25 cases） and PCIA （control group,25 cases） to relieve pain postperatively. The postop- erative visual analogue scale （VAS） of pain, Rameasay standard, the range of motion of knee joint, side effects and application of dolantin in treatment group were analyzed versus in the control group. Results In the early stage, VAS in treatment group was lower than that in control group （ （ P 〈 0.05 ）, and there was no difference in Rameasay standard between the two groups （ （ P 〉 0.05 ）. The ROM of the knee was higher in treatment group than that in control group. The incidence of side effect and application of doiantin was lower than that in control group. Conclusion Application of muhimodal analgesia can relieve pain early after total knee replacement,improve the ROM of the knee,with fewer side effects and application of dolantin.