丁丙诺啡透皮贴剂联合快速康复模式在全膝关节置换术后的应用

Application of transdermal patches of buprenorphine combined with rapid rehabilitation model after total knee arthroplasty

目的评价丁丙诺啡透皮贴剂联合快速康复模式在全膝关节置换术(TKA)患者术后的早期临床疗效。方法63例行TKA患者随机分成丁丙诺啡透皮贴剂联合快速康复模式组(A组,30例)和传统的常规围术期管理组(B组,33例),比较两组术后膝关节VAS疼痛评分、活动度(ROM)、美国纽约特种外科医院(HSS)评分以及患者对术后镇痛的满意度、不良反应的发生情况。结果与B组相比,A组术后VAS疼痛评分降低,膝关节ROM、HSS评分以及患者对术后镇痛的满意度均增加(P<0.05或P<0.01);但两组不良反应发生率差异无统计学意义(P>0.05)。结论丁丙诺啡透皮贴剂联合快速康复模式能有效减轻TKA术后早期的疼痛程度、改善膝关节功能,符合术后早期康复的要求。

Objective To evaluate the early clinical efficacy of transdermal patches of buprenorphine combined with rapid rehabilitation model in the patients after total knee arthroplasty（TKA）.Methods Sixty-three patients underwent TKA were randomly divided into two groups of A（treated with transdermal patches of buprenorphine combined with rapid rehabilitation model,30cases）and B（treated with traditional perioperative management,33cases）.The VAS pain score,range of motion（ROM）,hospital for special surgery（HSS）score,patients satisfaction on postoperative analgesia and adverse effects were compared between two groups.Results Compared with group B,VAS pain score was decreased,while ROM,HSS score and patients satisfaction on postoperative analgesia were significantly increased in group A（P〈0.05 or P〈0.01）.There was no statistical difference in the incidence of adverse effects between groups of A and B（P〉0.05）.Conclusion The transdermal patches of buprenorphine combined with rapid rehabilitation model can effectively reduce postoperative pain and improve knee function in the early stage after TKA,which meets the requirements of early rehabilitation.