论文部分内容阅读
目的:研究普瑞巴林与连续股神经阻滞(CFNB)用于人工全膝关节置换围手术期的镇痛效果.方法:将120例拟行单侧人工全膝关节置换术的骨关节炎患者随机分为基础镇痛组(B)组:经静脉自控镇痛(PCIA)+基础镇痛方案;普瑞巴林(P)组:PCIA+基础镇痛方案+普瑞巴林;连续股神经阻滞(NB)组:CFNB+基础镇痛方案;联合应用(C)组:CFNB+基础镇痛方案+普瑞巴林.比较4组患者术后3月内不同时间点的疼痛视觉模拟评分(visual analog scale,VAS)和主、被动关节活动范围(range of motion, ROM)及术后不良反应、补充性镇痛、镇痛总体满意度以评价各组的临床效果.结果:NB组、C组术后1、4、12、24 h,2 d静息与运动VAS评分、主、被动ROM评分、术后补充性镇痛剂量、恶心呕吐等不良反应发生率、患者满意度与B组、P组比较,差异均有统计学意义;术后3个月静息VAS评分P组、C组显著低于B组、NB组;C组术后3、5 d主、被动ROM评分与B组、P组比较,差异有统计学意义.结论:CFNB对人工全膝关节置换术(TKA)术后早期疼痛和关节活动有较理想的控制和改善效果,且无需吗啡类药物补充镇痛,不良反应少.普瑞巴林可降低术后康复期关节周围慢性疼痛综合征的发生率.两者联合应用互为补充,改善TKA术后早期和后期疼痛和康复,是较为理想的镇痛方案.“,”Objective:To compare the analgesic effects of pregabalin and continuous femoral nerve block(CFNB) in total knee arthroplasy(TKA) procedures.Methods: 120 patients undergoing TKA were randomly divided into four groups: Group B(basic analgesia),Group P(pregabalin and basic analgesia),Group NB(CFNB basic analgesia) and Group C (Combination of pregabalin, CFNB, and basic analgesia). The Visual Analog Scale (VAS), passive range of motion(ROM), postoperative adverse reactions, supplementary analgesic, analgesia overall satisfaction of patients at different time points within 3 months post operation were measured to evaluate clinical effects among each group.Results: At 1, 4, 12, 24 h, and 2 d post operation, the VAS and ROM scores, the consumption of supplementary meperidine hydrochloride and adverse effect between Group NB, Group C and Group B,Group P had statistical differences. The VAS and ROM scores at postoperative 3 d and 5 d, the VAS scores at rest at postoperative 3 month had statistical difference between Group C and Group B,Group P.Conclusion: CFNB had positive results in pain-relieving during early postopertative period of TKA with less supplementary meperidine hydrochloride and adverse reactions. Combination CFNB and pregabalin was a relatively ideal analgesic protocol at early and later TKA postoperative period.