多模式镇痛对老年全膝关节置换镇痛效果及应激反应的影响

发布时间：2018-04-03 05:36

本文选题：镇痛　切入点：全膝关节置换　出处：《中国老年学杂志》2017年11期

【摘要】：目的多模式镇痛对老年全膝关节置换的镇痛效果及应激反应的影响。方法选择首次行单侧全膝关节置换术老年患者140例,根据随机数字法分为多模式镇痛组和对照组。对照组患者手术结束前15 min连接静脉自控镇痛(PCIA)泵,多模式镇痛组患者手术结束前15 min给予吗啡1.5~2 mg,然后连接PCIA泵,对两组患者术后12 h、24 h和48 h进行静息时和活动时视觉模拟评分(VAS)和Ramsay镇静评分(RSS),测定术后24 h时血清白细胞介素(IL)-6和C反应蛋白(CRP)水平。结果静息时,多模式镇痛组24 h、48 h VAS均低于对照组(P0.05),两组12 h VAS比较差异无统计学意义(P0.05)。活动时,多模式镇痛组12 h、24 h、48 h VAS均低于对照组(P0.05)。多模式镇痛组12 h、24 h、48 h RSS均低于对照组(P0.05)。术后24 h,多模式镇痛组血清IL-6和CRP水平均低于对照组(P0.05)。结论多模式镇痛对老年全膝关节置换的镇痛效果较好,可以减轻术后应激反应。
[Abstract]:Objective to evaluate the analgesic effect and stress response of multi-mode analgesia in elderly patients with total knee arthroplasty.Methods 140 elderly patients undergoing unilateral total knee arthroplasty for the first time were randomly divided into multi-mode analgesia group and control group.The patients in the control group were treated with morphine 1.5mg 15 min before operation and then connected with PCIA pump 15 min before the end of operation. The patients in the multi-mode analgesia group were treated with morphine 1.5mg 15 min before the end of operation, and the patients in the multi-mode analgesia group were treated with PCIA pump.Visual analogue score (VAS) and Ramsay sedative score (Ramsay sedative score) were performed at 24 h and 48 h after operation, and the serum levels of interleukin-6 (IL6) and C-reactive protein (CRP) were measured at 24 h after operation.Results at rest, the VAS at 24 h and 48 h in the multi-mode analgesia group was lower than that in the control group (P 0.05). There was no significant difference in VAS between the two groups at 12 h.The VAS of multi-mode analgesia group was lower than that of control group (P 0.05) at 12 h, 24 h and 48 h.The RSS of multi-mode analgesia group was lower than that of control group (P 0.05).24 hours after operation, the levels of serum IL-6 and CRP in the multimode analgesia group were lower than those in the control group (P 0.05).Conclusion the analgesic effect of multi-mode analgesia in elderly patients with total knee replacement is better and the stress response can be alleviated.
【作者单位】：浙江省台州医院麻醉科;
【分类号】：R614

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