耳穴贴压联合塞来昔布超前镇痛在全膝关节置换术中的应用

摘要

Objective To observe the analgesic preemptive analgesic effect of auricular point plus Celecoxib in total knee arthroplasty (TKA).Method Forty-six patients who were going to receive unilateral TKA were randomized into a treatment group and a control group, 23 in each group. Patients in the treatment group began to receive auricular point sticking plus Celecoxib for preemptive analgesia 3 days ahead of the operation, while the control group only received Celecoxib. The pain score at 6 h, 12 h, 24 h, and 48 h after operation, and the case number of supplementing Pethidine Hydrochloride and the case number of having adverse reactions were compared between the two groups.Result The treatment group was significantly lower than the control group in comparing the pain scores at 6 h, 12 h, and 24 h after operation (P<0.05), while the difference at 48 h was statistically insignificant (P>0.05); the treatment group was significantly lower than the control group in comparing the case number of supplementing Pethidine Hydrochloride and the case number of having adverse reactions (P<0.05).Conclusion Auricular point sticking plus Celecoxib can produce a significant preemptive analgesic effect in TKA, and its analgesic effect is stronger than using Celecoxib alone. It can reduce the use of analgesics after operation and decrease the occurrence of adverse reactions.%目的：观察耳穴贴压联合塞来昔布超前镇痛在全膝关节置换术中的镇痛效果。方法选择行单侧全膝关节置换术的患者46例，随机分为治疗组和对照组，每组23例。治疗组患者于术前3天开始予耳穴贴压联合塞来昔布口服超前镇痛，对照组单予塞来昔布口服。比较两组患者术后6 h、12 h、24 h、48 h的疼痛评分和术后追加盐酸哌替啶例数及不良反应发生情况。结果治疗组术后6 h、12 h、24 h疼痛评分均低于对照组(P＜0.05)，两组48 h的疼痛评分差异无统计学意义(P＞0.05)；治疗组追加盐酸哌替啶例数和不良反应发生例数均低于对照组(P＜0.05)。结论耳穴贴压联合塞来昔布口服超前镇痛在全膝关节置换术中镇痛效果明显，其镇痛作用强于单用塞来昔布，并能减少使用术后镇痛药物，降低不良反应发生率。