超前镇痛在屈肌腱松解术后早期康复中的临床疗效观察

Clinical effect of preemptive analgesic on early rehabilitation after tenolysis of flexor tendon adhesion

目的评估超前镇痛对肌腱松解术后手指早期康复训练中早期镇痛和功能恢复的影响。方法择期行肌腱松解术患者40例,随机分为超前镇痛组和镇痛泵组各20例,超前镇痛组给予塞来昔布和帕瑞昔布联合镇痛,镇痛泵组给予静脉镇痛泵镇痛。记录术后6、12、24、48、72h静息时视觉模拟评分法(visual analogue scale,VAS)评分;术后1、2周采用手指总的主动活动度(total active motion,TAM)系统评价法对患者手指功能进行评定。结果超前镇痛组和镇痛泵组静息时VAS评分均呈逐渐降低趋势,且超前镇痛组降低更明显(P<0.05);超前镇痛组和镇痛泵组手指TAM值呈逐渐增大趋势,但超前镇痛组增大的幅度更明显(P<0.05)。结论超前镇痛在肌腱松解术后早期康复训练中镇痛作用明显,可显著提高患者手指活动度。

Objective To evaluate the effect of preemptive analgesic on postoperative analgesia and early rehabilitation after tenolysis of flexor tendon adhesion.Methods Forty patients scheduled for tenolysis of flexor tendon adhesion were randomly divided into two groups（n=20）：preemptive analgesic group and patient controlled analgesia group.Celecoxib and parecoxib were given in the preemptive analgesic group,patient-controlled intravenous analgesia with sufentanil were adepted in the patient controlled analgesia group.Pain at rest was evaluated using visual analogue scale（VAS）score at 6,12,24,48,72 hafter the operation.Total active motion（TAM）were used to assess the function of the involved digits one and two week after the operation.Results The VAS score at rest between two groups was decreased,but the patient controlled analgesia group decreased slowly（P〈0.05）.TAM in the two groups was increased,but the patient controlled increased slowly（P〈0.05）.Conclusion The preemptive analgesic can improve the postoperative analgesia and digits rehabilitation for the patients undergoing tenolysis of flexor tendon adhesion.