塞来昔布超前镇痛对患者全髋关节置换术后的影响

The preeptive anaigesic effect with celebrex in the operation of total hip replacement

目的:观察塞来昔布(西乐葆)超前镇痛对全髋关节置换术后的疼痛评分、镇痛泵的按压次数、髋关节活动度的影响。方法:将46例患者随机分为观察组和对照组,观察组于术前1 h给予塞来昔布(西乐葆)400 mg加5 mL温水口服,对照组术前禁食禁饮;两组术后均采用芬太尼静脉自控镇痛及每12 h给予塞来昔布(西乐葆)200 mg口服。分别于术后8 h、16 h、24 h、48 h、72 h比较两组患者疼痛评分、镇痛泵的按压次数及术后1周、2周的髋关节活动度。结果:观察组术后最痛程度、72 h内平均疼痛程度均小于对照组(P<0.05);观察组术后24 h内镇痛泵的按压次数少于对照组(P<0.05);观察组术后1周、2周的髋关节活动度明显高于对照组(P<0.05)。结论:塞来昔布(西乐葆)超前镇痛能减轻患者全髋关节置换术后的疼痛,同时减少了镇痛泵的按压次数,改善髋关节活动范围,有利于增强患者康复的信心,早期下地负重,减少卧床并发症发生率,提高生活质量。

Objective：To observe the preeptive analgesic effect with celebrex（ celeboxib capsules） in the pain score,the press of PCA, the motion of hip in the total hip replacement. Method ：46 paients scheduled for the total hip replacement were randomly derided into two groups. The observation group received 400 mg celebrex （celeboxib） with 5 ml water 1 h before operation, while those of the comparison group didnt. The two groups received PCA and celebrex（ celeboxib capsules）per 12 h after operation,to assess the pain score ,the press of PCA at the time of 8,16,24,48,72 h after operation and the motion of the hip at 1,2W after operation. Result：the postoperative pain and the aver-age pain in 72 h were lighter than the comparison group （ P 〈 0.05 ）, the observation group press of PCA in 24 h of postoperative is less than comparison group （ P 〈 0.05 ）, the function of hip in observation group at 1、2W after operation were higher than comparison group （P 〈 0.05 ）. Concision： the preeptive analgesic with celebrex （ celeboxib capsules） could release the pain of the total hip replacement, and de-crease the press of PCA, improve the function of the hip, increase the confidence of paient rehabilitation, immediate full weight - bearing, decrease the rate of complication of bedrid, improve the quality of life.