塞来昔布对膝关节镜下外科治疗患者疼痛的影响

Impact of Celecoxib on pain in patients undergoing knee arthroscopic surgery

目的探讨塞来昔布对膝关节镜下外科治疗患者疼痛的影响。方法选取2013年6月-2014年12月该院收治的42例行膝关节镜手术患者为研究对象,并随机分为塞来昔布组和安慰剂组,两组各21例。塞来昔布组在入院后第2天开始口服塞来昔布胶囊(200 mg,2次/d,持续3 d),安慰剂组服用在外形上与塞来昔布胶囊完全一致的安慰剂。比较两组服药前后静息、运动状态下的视觉模拟评分法(VAS)评分以及两侧的痛阈、耐痛阈,并采用Pearson相关性分析塞来昔布组各指标服药前后的变化差值之间的相关性。结果与本组服药前以及安慰剂组服药后相比,塞来昔布组服药后静息及运动状态下VAS评分均明显降低(P<0.05),两侧的痛阈显著升高,耐痛阈差异均无统计学意义(P>0.05),而安慰剂组服药前后的静息、运动状态下VAS评分以及两侧的痛阈、耐痛阈比较,差异无统计学意义(P>0.05)。塞来昔布组中静息VAS评分变化差值与运动VAS评分成显著正相关(P<0.05),静息、运动VAS评分均与两侧痛阈的变化差值呈显著负相关(P<0.05),健侧痛阈变化差值与患侧痛阈变化差值呈显著正相关(P<0.05),而健侧、患侧耐痛阈变化差值均与其他指标无明显相关性(P>0.05)。结论对于行膝关节镜手术的患者而言,术前口服塞来昔布可显著降低患者的疼痛程度,提高痛阈水平,发挥其预防性镇痛的效果,且服药前后疼痛程度的改变与痛阈的变化可能有关。

【Objective】To investigate the impact of Celecoxib on pain in patients undergoing knee arthroscopic surgery. 【Methods】42 patients undergoing knee arthroscopic surgery from June 2013 to December 2014 were enrolled in the study and randomly divided into Celecoxib group and placebo group, 21 cases each. Patients in Celecoxib group were given Celecoxib（200 mg, 2 times/d, last 3 d） while cases in placebo group were given placebos whose shape were the same as Celecoxib capsules. Instead, resting and moving Visual Analogue Scale（VAS） scores and pain threshold, pain tolerance of both lower limbs were compared before and after treatment between two groups.Pearson correlation analysis was performed to evaluate the relation among change of these indexes before and after treatment in Celecoxib group.【Results】Compared with that before treatment in Celecoxib group and that after treatment in placebo group, Resting and moving VAS scores all significantly decreased（P〈0.05）, on both sides of the pain threshold was significantly increased（P〈0.05）, pain tolerance was no statistically significant difference（P〉0.05）. There were no significant differences on all VAS scores and pain threshold, pain tolerance threshold of both lower limbs before and after treatment in placebo group（P〉0.05）. In Celebrexib group, change of resting VAS score had a significant positive correlation with that of moving VAS score（P〈0.05）. Change of resting and moving VAS scores all had a significant negative correlation with that of pain threshold of both lower limbs（P〈0.05）. Change of pain threshold of affected lower limb had a significant positive correlation with that of normal lower limb（P〈0.05）.And there were no significant correlation between change of pain tolerance threshold with that of other indexes（P〈0.05）. 【Conclusions】For patients undergoing knee arthroscopic surgery, Celebrexib could significantly reduce preoperative pain and increase their pain threshold, which could play an important role in preventive analgesia. There may be relation between change of pain and pain threshold.