吡罗昔康贴片在膝关节置换术后镇痛效果研究

The analgesia effect of piroxicam patches on total knee arthroplasty

目的研究吡罗昔康贴片用于人工全膝关节置换围手术期的镇痛效果。方法选取本科2014年3月-12月入院在全麻下行单侧初次人工全膝关节置换术的骨关节炎患者218例,以随机数字表按简单随机分组法分为吡罗昔康组109例和对照组（不使用吡罗昔康）109例,比较两组患者术后疼痛视觉模拟评分（visual analog scale,VAS）和主、被动关节活动度（range of motion,ROM）及术后不良反应、补充性镇痛、镇痛满意度以评价临床镇痛效果。结果两组患者在年龄、身高、体质量、体质量指数、性别、假体、膝关节HSS评分、术前ROM、术前行走VAS、手术时间方面均未见统计学差异。两组术后静息与运动VAS评分、主动活动度、术后补充性镇痛差异均有统计学意义（P≤0.05）。两组患者术后住院天数、不良反应发生率、术后满意度差异无统计学意义（P〉0.05）。结论术后外用吡罗昔康贴片对于初次人工全膝关节置换术术后早期镇痛效果明显,改善关节主动活动度,且术后补充性镇痛应用较少。可与全身药物联合应用,缓解膝关节置换术后疼痛。

Objective To explore the analgesia effect of piroxicam patches during the perioperative period of total knee arthroplasty. Method Two hundred and eighteen participants were selected from the ostarthritis patients who were admitted to our department from March to December,2014 and underwent primary total knee arthroplasty under general anesthesia. They were equally divided into two groups, experimental group of patients with piroxicam patches and contrast group of patients without patches. The analgesia effect was assessed and compared according to the pain visual analog scale of the patients,the range of motion of active and passive joints,the postoperative adverse reaction, supplementary analgesia and the analgesia satisfaction. Results There was no significant statistical differences between the two groups in age,height,weight,body mass index, gender,prosthesis,HSS of knee joints,preoperative ROM,preoperative walk VAS and operation time. No significant difference sexisted in postoperative length of stay,rate of adverse reaction and postoperative satisfaction between patients of the two groups. Nevertheless,there were statistically significant differences（P ≤ 0.05） in VAS of postoperative tranquilization and motion and ROM of active and passive joints.Conclusion In first total knee arthroplasties,piroxicam patches are effective for early postoperative analgesia; they can improve the active ROM of joints and can reduce the need for postoperative supplementary drugs. Combined with oral or intravenous drugs,piroxicam patches can be used for analgesia after knee arthroplasty.