帕瑞昔布钠超前镇痛对全膝关节置换术后镇痛效果及血清TNF—α及IL-6的影响

目的探讨帕瑞昔布钠超前镇痛对全膝关节置换术后镇痛效果及血清TNF-α、IL-6的影响。方法行单侧全膝关节置换术患者86例，随机分为2组，每组各43例。观察组患者在切开皮肤前15min静脉注射帕瑞昔布钠40mg，对照组同一时间点静脉注射0．9％氯化钠注射液4ml。分别于术后1h、6h、12h、24h观察两组患者术后VAS评分，于手术切皮前15min、术后1h、6h、12h、24h检两组患者血清TNF-α、IL-6水平。结果两组患者术后1h、6h、12h、24hVAS评分比较，观察组均显著低于对照组（P〈0．05）；两组患者术后6h、12h、24h血清TNF-α水平与切皮前15min比较均明显升高；与对照组同一时间点比较，差异有统计学意义（P〈0．05）。两组患者术后1h、6h、12h、24h血清IL-6水平与切皮前15min比较均明显升高；与对照组同一时间点比较，差异有统计学意义（19〈0．05）。结论帕瑞昔布钠超前镇痛能有效减轻全膝关节置换术后的疼痛，抑制炎性因子的释放。

Objective To investigate the effects of parecoxib sodium preemptive analgesia on postoperative analgesia and serum TNF- α and IL-6 after total knee arthroplasty. Methods 86 cases of patients with unilateral TKA were randomly divided into two groups （ n=43 each ） . The patients in the observation group were received parecoxib sodium 40mg 15 min before incision, while 0.9% sodium chloride injection 4ml was injected in control group. The levels of serum TNF-α and IL-6 in the two groups were observed at lh, 6h, 12h and 24h after operation. The levels of serum TNF-α and IL-6 were measured before and after operation for 15min and lh, 6h, 12h and 24h after operation. Results The VAS of patients in observation group at lh, 6h, 12h and 24h were lower than those in control group after operation （ P〈0.05 ） . The levels of serum TNF-α in observation group at 6h, 12h and 24h were better than those in control group after operation （ P〈0.05 ） .The levels of serum IL-6 in observation group at lh, 6h, 12h and 24h were higher than those in the control group （ P〈0.05 ） . Conclusion Parecoxib sodium preemptive analgesia can reduce pain and affect the relief of inflammatory mediators in patients with total knee arthroplasty.