期刊文献+
任意字段
题名或关键词
题名
关键词
文摘
作者
第一作者
机构
刊名
分类号
参考文献
作者简介
基金资助
栏目信息

多模式镇痛在膝关节单髁置换中的应用

下载PDF
导出
摘要 目的探讨采用多模式联合镇痛对人工膝关节单髁置换术(UKA)后疼痛控制效果及功能恢复的影响。方法28例初次行单侧膝关节单髁置换患者,按随机序列法分为2组:观察组14例,以鸡尾酒(酮咯酸氨丁三醇30 mg+吗啡5 mg+肾上腺素0.3 mg+利多卡因200 mg混悬液)注射于假体周围关节囊、肌腱起止点及深筋膜等组织;对照组14例,以生理盐水注射在以上相同区域,比较2组术后6,12,24,48 h静息痛程度以及术后24,48 h的运动痛程度;比较术后24,48 h膝关节活动度。结果膝关节单髁置换术后6,12,24,48 h静息痛程度以及术后24,48 h的运动痛程度,观察组均较对照组疼痛评分降低,差异有显著意义(P<0.05);观察组24,48 h膝关节活动度大于对照组,差异有显著意义(P<0.05)。结论多模式镇痛可使UKA术后早期静息痛和活动痛得到明显减轻,术后早期膝关节活动度明显增加,提示围术期多模式镇痛能有效缓解UKA术后疼痛,促进患者膝关节功能恢复,为骨科术后疼痛治疗提供更多的选择。
作者 张自强 祁文兵 白明华 王小刚
机构地区 宝鸡市中医医院
出处 《基层医学论坛》 2016年第2期172-174,共3页 The Medical Forum
关键词 膝关节单髁置换 多模式镇痛 术后疼痛 功能锻炼
分类号 R687.4 [医药卫生—骨科学]
  • 相关文献

参考文献18

  • 1MAHESHWARI A V, BLUM Y C, SHEKHAR L, et al. Multimodal pain management after total hip and knee arthropMsty at the Ranawat Orthopaedic Center[J].Clin Orthop Relat Res, 2009,467(6): 1418-1423.
  • 2PARVATANENI H K, SHAH V P, HOWARD H, et al. Controlling pain after total hip and knee arthroplasty using a multimodal proteeol with local perlartieular injections: a prospective randomized study [J]. J Arthroplasty, 2007,22(6 Suppl 2) :33-38.
  • 3KRENZEL B A, COOK C, MARTIN C N, et al. Posterior capsular injections of ropivaeaine during total knee arthroplasty: a randomized, double-blind, placebo-controLled study [J]. J Arthroplasty, 2009,24( 6 Suppl) : 138-143.
  • 4BUSCH C A, SHORE B J, BHANDARI R, et al. Ffficaey of periartieular multimodal drug injection in total knee arthroplasty. A randomized trial[J]. J Bone Joint Surg Am, 2006,88(5) :959-963.
  • 5KEBLISH P A, BRIARD J L. Mobile-bearing unieompartmental knee arthmplasty: a 2-center studywith an ll-year (mean) followup [J]. J Arthroplasty, 2004,19 (7 Suppl2) : 87-94.
  • 6KOZINN S C, SCOTT R D. Currentconcepts review: unicompartmental totalarthroplasty[J]. Bone JointSurg Am, 2004,71 ( 3 ) : 145 - 146.
  • 7SOOHO0 N F, SHARIFI H, KOMINSKI G, et al. Costeffectiveness analysis ofunicompartmentalknee arthroplasty as an alternative to total knee arthroplasty for unieompartmental osteoarthritis [J]. J Bone JointSurg Am, 2006,88(9 ) : 1975-1982.
  • 8PATILS, COLWELL C W, EZZET K A, et al. Can normal knee kinematics berestored with unicompartmental knee replacement [J].J Bone JointSurg Am, 2005,87 (2) : 332-338.
  • 9ISAAC S M, BARKER K L, DANIAL I N, et al. Does arthroplasty type influence knee jointproprloception A longitudinal prospeetlve study comparing total and unicompartmental arthroplasty [J]. Knee, 2007,14 (3):212-217.
  • 10RIDDLE D L, J IRANEK W A, MCGLYNN F J. Yearly incidence of unicompamnental knee arthroplasty in the United States [J]. J Arthroplas.ty, 2008,23 (3) : 408-412.

二级参考文献22

  • 1袁红斌,朱秋峰,田谋利,刘虎,石学银.膝关节镜术后关节腔内注射芬太尼镇痛效果的临床观察[J].中国矫形外科杂志,2006,14(14):1104-1105. 被引量：7
  • 2Bonica JJ. Postoperative pain. In: Bonica JJ, ed. The management of pain. 2nd ed. Philadelphia: Lea and Febiger, 1990. 461-480.
  • 3Vendittoli PA, Makinen P, Drolet P, et al. A muhimodal analgesia protocol for total knee arthroplasty: a randomized, controlled study. J Bone Joint Surg(Am), 2006, 88: 282-289.
  • 4Busch CA, Shore BJ, Bhandari R, et al. Efficacy of periarticular muhimodal drug injection in total knee arthroplasty: a randomized trial. J Bone Joint Surg(Am), 2006, 88: 959-963.
  • 5Tanaka N, Sakahashi H, Sato E, et al. The efficacy of intra-articular analgesia after total knee arthroplasty in patients with rheumatoid arthritis and in patients with osteoarthritis. J Arthroplasty, 2001, 16: 306-311.
  • 6Heard SO, Edwards WT, Ferrari D, et al. Analgesic effect of intraarticular bupivaeaine or morphine after arthroseopie knee surgery: a randomized, prospective, double-blind study. Anesth Analg, 1992, 74: 822-826.
  • 7Woolf CJ, Chong MS. Preemptive analgesia-treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg, 1993, 77: 362-379.
  • 8Stein C, Comisel K, Haimerl E, et al. Analgesic effect of intraarticular morphine after arthroscopic knee surgery. N Engl J Med, 1991, 325:1123-1126.
  • 9Joris JL, Dubner R, Hargreaves KM. Opioid analgesia at peripheral sites: a target for opioids released during stress and inflammation? Anesth Analg, 1987, 66: 1277-1281.
  • 10Lundin O, Rydgren B, Sward L, et al. Analgesic effects of intra-articular morphine during and after knee arthroscopy: a comparison of two methods. Arthroscopy, 1998, 14: 192-196.

共引文献84

基层医学论坛
2016年 第2期

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部