双膝关节置换术中关节腔周围注射混合药物镇痛效果的临床配对研究

Analgesia efficacy of periarticular multimodal drug injections after simultaneous bilateral total knee arthroplsaty

目的观察关节腔周围注射混合药物在同期双侧全膝关节置换术(TKA)中的镇痛效果。方法 60例行同期双侧TKA患者共120例膝关节,随机分为实验组和对照组,每组60例膝关节。实验组膝关节周围注射镇痛药物(盐酸罗哌卡因+注射用甲泼尼龙琥珀酸钠+肾上腺素),对照组没有运用关节周围注射药物。术前、术后分别记录双侧静止与活动视觉模拟疼痛评分(VAS)、膝关节HSS评分以及术后引流量。结果术后6、12、24 h实验组静止和活动时VAS评分均低于对照组(P<0.05);但术后48、72 h实验组与对照组静止和活动时VAS评分无统计学差异(P>0.05);两组间术后引流量及HSS评分无统计学差异(P>0.05)。结论关节腔周围注射混合药物可以有效缓解TKA术后早期疼痛。

Objective To investigate the analgesia effect during the simultaneous bilateral total knee arthroplsaty（TKA） combined with periarticular multimodal drug injection.Methods A total of 120 knees of 60 patients who underwent simultaneous bilateral TKA were randomly divided into two groups.The study group received periarticular multimodal drug injection of ropivacaine,compound methylprednisolone and epinephrine at operation.The control group received nothing.VAS,HSS and the drainage volume of the every knee were recorded,respectively.Results The VAS in study group was lower than that in control group at 6,12,24 hours（P0.05）,but there was no difference at 48 or 72 hours between the two groups（P0.05）.There were no significant differences in the drainage volume of the knee and HSS between two groups（P0.05）.Conclusion Periarticular multimodal drug injections during TKA can relieve pain early after TKA.