高乌甲素超前镇痛联合术后复合舒芬太尼PCIA用于膝关节术后的临床观察

发布时间：2018-05-25 18:30

本文选题：PCIA + 全膝关节置换术　；参考：《山东中医药大学》2015年硕士论文

【摘要】：目的:观察高乌甲素超前镇痛联合术后复合舒芬太尼PCIA在全膝关节置换术后镇痛中有无优越性方法:将60例全膝关节置换术患者随机分为三组,A组(对照组)单纯舒芬太尼PCIA术后镇痛,B组应用高乌甲素复合舒芬太尼PCIA术后镇痛,C组术前高乌甲素超前镇痛并术后复合舒芬太尼PCIA镇痛,分别记录术后6h,12h,24h,48h,48h静止与活动状态下视觉模拟疼痛评分(VAS),术后12h,24h,48h,72h,,1周和2周的膝关节活动度(主要记录术后主动屈曲度)以及术后出现的副作用(恶心,呕吐,皮肤瘙痒,嗜睡和注射吗啡的次数),术后2周时采用HSS表对患者进行评分。结果:对照A组单纯舒芬太尼PCIA术后镇痛,因药物浓度低,术后镇痛效果差与治疗组有明显差异(P0.05);高乌甲素超前镇痛联合术后复合舒芬太尼PCIA镇痛在静息状态下的镇痛效果优越于非超前镇痛组,差异有显著性(P0.05)。结论:本次研究高乌甲素超前镇痛联合术后复合舒芬太尼PCIA镇痛在TKA术后的效果,通过对比不同的镇痛方案,发现治疗组在术后可达到良好的镇痛效果,并且超前镇痛的效果在一定程度上优于复合镇痛组;因此本次研究认为高乌甲素超前镇痛联合术后复合舒芬太尼PCIA镇痛能有效控制TKA术后的疼痛,可达到优良的镇痛效果,安全性高,减低了术后的不良反应,可用TKA术后镇痛。
[Abstract]:Objective: to observe the advantages of combination of aconitine preemptive analgesia and sufentanil PCIA in postoperative analgesia after total knee arthroplasty: 60 patients undergoing total knee arthroplasty were randomly divided into three groups: group A (control group) Simple sufentanil PCIA postoperative analgesia group B was treated with aconitine combined with sufentanil PCIA for preemptive analgesia before operation and combined with sufentanil PCIA for postoperative analgesia. The visual analogue pain score (VASA) was recorded at 6 h, 12 h, 24 h, 48 h and 48 h, respectively. The knee joint motion (mainly active flexion) and side effects (nausea, vomiting, pruritus) were recorded at 12 h, 24 h, 48 h, 72 h and 2 weeks postoperatively respectively, and the postoperative side effects (nausea, vomiting, pruritus) were recorded. The number of sleepiness and morphine injection was evaluated by HSS scale 2 weeks after operation. Results: in group A, simple sufentanil was used for postoperative analgesia due to low concentration of sufentanil. There was a significant difference in analgesic effect between the two groups (P 0.05), and the analgesic effect of aconitine preemptive analgesia combined with sufentanil PCIA was superior to that of non-preemptive analgesia group (P 0.05). Conclusion: in this study, the analgesia effect of advanced analgesia combined with sufentanil after TKA was studied. By comparing different analgesic schemes, it was found that the treatment group could achieve good analgesic effect after operation. And the effect of preemptive analgesia was better than that of compound analgesia group to some extent. Therefore, this study considered that advanced analgesia combined with combined sufentanil PCIA analgesia can effectively control the pain after TKA, and can achieve good analgesic effect. High safety, reduced postoperative adverse reactions, TKA postoperative analgesia can be used.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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