鸡尾酒在膝关节置换术后的应用效果

Application effect of cocktail after knee joint replacement

目的探讨鸡尾酒在膝关节置换术后的应用效果。方法选取2012~2016年在大连市第二人民医院骨科行单侧人工全膝关节置换术及膝关节单髁置换术的患者各60例,根据入院时间分为两组,每组30例。观察组(2014年后入院)采用术中鸡尾酒镇痛,对照组(2014年前入院)术中未应用任何止痛药物。观察术后24 h、48 h、3 d、7 d、14 d时患膝静息、运动时的NRS评分及不良反应发生情况。结果全膝关节置换术和单髁关节置换术中,观察组患者术后24 h、48 h、3 d运动及静息时的NRS评分均低于对照组,差异有统计学意义(P<0.05);术后7、14 d组间运动及静息时的NRS评分比较差异无统计学意义(P>0.05)。观察组术后不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论全膝关节置换术及单髁置换术中关节腔内注射鸡尾酒疗法进行术后镇痛的效果明确,不良反应较少,安全性较高,可为临床工作中术后镇痛方案提供更好的选择。

Objective To analyze the application effect of cocktail after knee joint replacement.Methods 60 patients un- derwent the unilateral total knee arthroplasty and 60 patients underwent the single knee replacement of knee joint in Department of Orthopaedics of the Second People＇s Hospital of Dalian City from 2012 to 2016 were selected and they were divided into the two groups according to admission time,and there were 30 cases in each group.The observation group （admission after 2014） was given cocktail analgesia during operation,while the control group （admission before 2014） were not given any analgesic drugs during operation.NRS score of sicken knee at rest and during exercise after 24 h,48 h,3 d,7 d,14 d surgery and the incidence of adverse reaction were observed.Results For total knee arthroplasty and single condylar joint replacement,NRS score at rest and during exercise after 24 h,48 h,3 d operation in the observation group were significantly lower than those of the control group,and there was a statistical difference （P〈0.05）,and there was no statistical difference of NRS score at rest and during exercise after 7 d,14 d surgery between groups （P〉 0.05）.The incidence rate of adverse reaction the observation group after operation was lower than that of the control gorup,with statistically significant difference （P〈0.05）.Conclusion Adopting cocktail therapy for postoperative analgesia in total knee arthroplasty and unicompartmental knee artbroplasty has definite analgesic effect,and the adverse reaction is fewer,the safety is higher,which can provide better choice for postoperative analgesia regimen in clinical work.