酮咯酸氨丁三醇复合舒芬太尼在全膝关节置换术后的镇痛效果

Effects of ketorolac tromethamine combined with sufentanil on postoperative analgesia in patients undergoing total knee athroplasty

目的观察酮咯酸氨丁三醇复合舒芬太尼在全膝关节置换术后镇痛的临床效果及安全性。方法选择择期行全膝关节置换术的患者60例，术后行患者静脉自控镇痛（PCIA）治疗。随机分为两组，每组30例。T组：酮咯酸氨丁三醇180mg，舒芬太尼50μg，阿扎司琼10mg；S组：舒芬太尼100μg，阿扎司琼10mg。两组均用0．9％生理盐水稀释至100ml，手术缝皮时接镇痛泵。注射速度为2ml／h，负荷量2．0ml，PCA量为0．5m1，锁定时间为15min。术后采用视觉模拟评分（VAS），观察术后4、8、12、24、48h疼痛评分，比较两组的镇痛效果及不良反应。结果两组患者在术后4、8、12、24h的VAS评分比较，差异均无统计学意义（P〉0．05）；T组不良反应发生率明显比S组低（P〈0．05）。结论酮咯酸氨丁三醇复合舒芬太尼可用于全膝关节置换术后镇痛，效果确切，不良反应少，优于单独使用舒芬太尼。

Objective To observe the effect and security of ketorolac tromethamine combined with sufentanil on postoperative analgesia in patients undergoing total knee athroplasty. Methods Sixty patients scheduled for elective total knee athroplasty were randomly derided into two groups： group T and group S, 30 cases in each group. Group T received ketorolac tromethamine 180 mg, sufentanil 50 ixg and azasetron 10 mg, and group S received sufentanil 100 μg and azasetron 10 mg. All the patients received patient-controlled intravenous first dose of 2 ml, bolus dose analgesia （PCIA） before the end of the operation at the rate of 2 ml/h, of 0.5 ml, and the lock time was 15 min. The visual analogue score（VAS）at 4, 8, 12, 24, 48 h after operation and adverse reaction were observed and recorded.Results There was no significant difference in VAS scores at 4, 8, 12, 24, 48 h after operation be- tween the two groups （P 〉 0.05 ）. The incidence of adverse reactions in group T was significantly lower than that in group S. Conclusions Ketorolac tromethamine combined with sufentanil can provide satis- factory postoperative analgesia in patients undergoing total knee athroplasty with lower incidence of ad-verse reactions, and is superior to sufentanil alone.