闫昌葆;陈百成;刘虎;赵宝辉;李嘉;

• 1:河北医科大学第三医院关节骨科

摘要(Abstract)：

[目的]研究塞来昔布在膝关节镜下自体腘绳肌腱前交叉韧带重建围术期应用的镇痛效果。[方法]采用随机对照研究方法,对90例前交叉韧带损伤患者行膝关节镜下自体腘绳肌腱重建术,随机分为3组,其中A组应用传统PCA镇痛,B组应用塞来昔布辅助曲马多镇痛,C组采用塞来昔布超前镇痛辅助曲马多镇痛。通过比较3组的术后各时间点VAS评分、术后不良反应发生率及辅助曲马多用量来比较3种方法的临床效果。[结果]术前3组患者年龄、体重、病情等基本情况无差别。术后6、12、24、48h,C组及A组VAS评分无差别且均小于B组(P6,12,24,48<0.05);术后A组不良反应发生率为43.3%。大于B组的16.7%及C组的20.0%(x2=6.3920,P=0.0115);术后A组辅助曲马多用量最少,而B组最多(F24=84.93,P24<0.0001;F48=117.13,P48<0.0001)。术后各组中患者均恢复良好,伤口均一期愈合,未出现严重的并发症及过敏反应。[结论]膝关节镜下自体腘绳肌腱前交叉韧带重建围术期应用塞来昔布超前镇痛辅助盐酸曲马多的镇痛方法,其镇痛效果好,不良反应低,具有良好的临床效果和安全性。

关键词(KeyWords)： 前交叉韧带重建;镇痛;塞来昔布

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 闫昌葆;陈百成;刘虎;赵宝辉;李嘉;

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参考文献(References)：

• [1]Reuben SS,Sklar J.Pain management in patients who undergo outpa-tient arthroacopic aurgery of the knee[J].J Bone Joint Surg(Am),2000,12:1754-1766.
• [2]Dauri M,Polzoni M,Fabbi E,et al.Comparison of epidural,continuous femoral block and intra articular analgesia after anterior cruciate liga-ment reconstruction[J].Acta Anaesthesiol Scand,2003,47:20-25.
• [3]Moberly JB,Xu J,Desjardins PJ,et al.A randomized,double-blind,celecoxib and placebo-controlled study of the effectiveness of CS-706in acute postoperative dental pain[J].Clin Ther,2007,3:399-412.
• [4]Reuben SS,Gutta SB,Maciolek H,et al.A comparison of local in-traarticular anesthesia versus general anesthesia for ambulatory arthro-scopic knee surgery[J].J Ambulatory Surgery,2005,1:39-44.
• [5]郝永强,干耀恺,朱振安.塞来昔布对骨科围手术期镇痛的疗效评估[J].中国矫形外科杂志,2007,2:131-133.
• [6]Romsing J,Moiniche S.Asystematic reviewof COX-2inhibitors com-pared with traditional NSAIDs,or different COX-2inhibitors for post-operative pain[J].Acta Anaesthesiol Scand,2004,5:525-546.
• [7]Gimbel JS,Brugger A,Zhao W,et al.Efficacy and tolerability of cele-coxib cersus hydrocodone/acetaminophen in the treatment of pain af-ter ambulatory orthopedic surgery in adults[J].Clin Ther,2001,2:228-241.
• [8]Gatt CJ,Parker RD,Tetzlaff JE,et al.Preemptive analgesia:its role and efficacy in anterior cruciate ligament reconstruction[J].Am J Sports Med,1998,26:524-529.
• [9]杨林,郭艾,徐本明,等.西乐葆超前镇痛在髋关节置换手术的应用[J].中国矫形外科杂志,2007,14:1065-1068.
• [10]Stiller Y,Lundblad H,Weidenbielm L,et al.The addition of tramadol to morphine via patient-controlled analgesia does not load to better post-operative pain relief after total knee arthroplasty[J].Acta An-aesthesiol Scand,2007,3:322-330.