塞莱昔布超前镇痛用于膝关节镜手术的研究

目的 研究塞莱昔布超前镇痛对膝关节镜手术术后疼痛、关节活动情况及关节液内前列腺素E2(PGE2)的影响.方法 将40例膝关节镜手术患者随机均分为观察组和对照组,观察组术前3 d给予塞莱昔布200 mg,每天2次;对照组给予安慰药(复合维生素片).采用联合腰麻,手术开始前抽取关节液1～2 ml,检测PGE2浓度.术前、手术结束及术后2、4、8、12、24、48 h进行镇痛效果评估,观察术后膝关节活动情况.结果 观察组关节液中PGE2浓度明显低于对照组(P＜0.01).观察组术前VAS明显低于对照组(P＜0.01),术后各时点VAS两组间差异无统计学意义;但观察组术后膝关节活动度明显大于对照组(P＜0.05).结论 塞莱昔布超前镇痛用于膝关节镜手术,能明显减轻炎症反应,增加术后膝关节活动度,有利于术后恢复.

Preemptive analgesia with celecoxib in patients underwent arthroscopic surgery

Objective To study the influence of preemptive analgesia with celecoxib on the intensity of pain,recovery of joint function in the early postoperative period and the levels of synovia prostaglandin E2(PGE2) in the patients underwent arthroscopic surgery.Methods Forty patients scheduled for arthroscopic surgery were randomly alocated into celecoxib group(C) or placebo group(P) with 20 cases each.Celecoxib 400 mg in group C or placebo in group P was given daily for 3 days before surgery.The operation was performed under combine spinal and extradural anesthesia.Pain intensity was evaluated using visual analog scale(VAS) before and after operation,and the recovery of joint function was assessed as well.The level of PGE2 in synovia was measured with PGE2 EIA kit.Results The VAS score was significantly lower in group C than that in group P before operation(P<0.01),which was not remarkably different between the two groups after operation.In patients of group C,a significantly better recovery of joint function was seen as compared with those of group P after operation(P<0.05).The concentration of PGE2 in synovia was significantly lower in group C than that in group P(P<0.01).Conclusion Preemptive celecoxib analgesia can decrease the intensity of pain,promote the recovery of joint function in the early postoperative period in the patients underwent arthroscopic surgery.