围术期帕瑞昔布钠对全膝关节置换术后疼痛和功能恢复的影响

摘要

Objective To assess the potential benefits of parecoxib sodium on pain management and function recovery after total knee arthroplasty (TKA). Methods Thirty patients undergoing elective TKA were enrolled in this study receiving postoperative pain with either parecoxib sodium combined with continuous femoral nerve block (group PF) or CFNB alone (group F), All patients received CFNB before anesthesia, followed by combined spinal epidural anesthesia via L3-4 vertebral interspace. Group PF received 40 mg parecoxib sodium 15 min before incision and 12 h after surgery. Postoperative pain during rest and ambulation and active range of motion (ROM) were evaluated. Results Thirty patients had similar reduced rest pain, but VAS scores during ambulation were improved significantly in group PF when compared with group F. Active ROM also increased significantly in group PF than group F(P<0.05). Conclusion Perioperative parecoxib sodium markedly improved postoperative ambulatory pain and active ROM in the first two days after total knee arthroplasty, without increased risk of bleeding.%目的 本研究评估帕瑞昔布钠对全膝关节置换术后疼痛和功能恢复的影响.方法 择期行全膝关节置换术的患者30例.所有患者均于麻醉前行股神经置管,然后于L3～4间隙穿刺行腰-硬联合麻醉.患者被随机分为两组:帕瑞昔布钠联合连续股神经镇痛组(PF组)和连续股神经镇痛组(F组),其中PF组于切皮前15 min和术后12 h给予帕瑞昔布钠40 mg,F组给予生理盐水.术后对两组患者的静息和运动时的VAS评分以及膝关节主动活动度进行评估.结果 术后静息时两组VAS评分相似；而运动时的各时点VAS评分PF组显著低于F组(P＜0.05),同时膝关节的主动活动度PF组显著高于F组(P＜0.05).结论 联合应用帕瑞昔布钠的多模式镇痛提高了全膝关节置换术后股神经镇痛的效果,有利于患者运动功能的恢复,对出血无明显影响.