初次全膝置换术关节周围局部浸润镇痛的疗效分析

Efficacy of local infiltration analgesia in primary total knee replacement

目的:评价局部浸润镇痛在初次单侧全膝关节置换术(total knee replacement,TKR)多模式镇痛中的镇痛效果及安全性。方法:将22例骨关节炎初次单侧TKR手术的患者随机分为局部浸润镇痛组(A组)与无局部浸润镇痛组(B组),每组11例。比较患者术后膝关节静息疼痛视觉模拟评分(visual analog score,VAS)、膝关节活动度及并发症。结果:A组术后各时点的静息VAS评分均低于B组,术后8、12、24、48h A组静息痛VAS评分显著小于B组,术后24、48、72h A组关节活动度较B组明显增加。镇痛相关不良反应发生率差异无统计学意义。结论:以局部浸润镇痛为主的多模式镇痛在初次单侧TKR术后有较好的镇痛效果,有助于减轻术后早期疼痛,且没有明显的不良反应。

Objective ：To evaluate the analgesic efficacy and safety of local infiltration analgesia in a multimodal analgesia protocol for primary unilateral total knee replacement（TKR）. Methods： Twenty-two patients with osteoarthritis, scheduled to undergo primary unilateral TKR, were prospectively assigned to two groups（ n = 11 for each group）. Group A were managed with local infiltration analgesia, and group B with non-local infiltration analgesia. The two groups were evaluated regarding the resting pain by visual analog score （ VAS）, range of motion and complications after operation. Results ： Group A had lower VAS scores and post-operative VAS scoring at rest at 8,12,24 and 48 h, respectively, and better range of motion after operation as compared with group B. The adverse events associated with analgesia were not significant for the two groups. Conclusion ： This muhimodal analgesia protocol may produce better infiltration analgesic effects and early pain control for patients following TKR without significant adverse effects.