多模式镇痛方案在骨科术后疼痛治疗中的药物经济学评价

Cost-effectiveness Analysis of two kinds of analgesic regimens in treatment of postoperative pain in orthopedics

目的探讨多种术后镇痛方案用于骨科术后镇痛治疗的药物经济学评价。方法选择南京鼓楼医院(以下简称"我院")中度至重度疼痛的骨科术后患者304例为研究对象,随机分成多模式镇痛组(151例)和NSAIDs组(153例),分别给予多模式镇痛:经静脉患者自控镇痛(PCIA)+非甾体抗炎药(NSAIDs)和单独使用非甾体抗炎药(NSAIDs)治疗,疗程为1周,观察镇痛疗效并运用成本-效果法分析。结果多模式镇痛组、NSAIDs组显效率分别为77.48%、82.35%,总缓解率分别为96.03%、96.73%;各组均无严重不良反应发生。多模式镇痛组、NSAIDs组成本-效果比分别为15.04、9.91。结论术后1周内,多模式镇痛组对术后疼痛控制的总体效果与NSAIDs组相似,但总体成本略高于NSAIDs组。值得注意的是,术后最初的2 d内,多模式镇痛组的疼痛控制效果优于NSAIDs组,结果具有显著性差异。

Objective To investigate the cost-effectiveness of two programs in postoperative analgesic in orthopedics.Methods All 304 cases of patients with moderate to severe postoperative pain in Nanjing Drum Tower Hospital were randomly assigned to receive Patient-controlled intravenous analgesia(PCIA)+NSAIDs,NSAIDs for 7 days.A cost-effectiveness analysis was performed on two groups.Results The effective rates were 77.48%,82.35% respectively in the PCIA,NSAIDs groups,and the total remission rate was 96.03%,96.73% respectively.No serious adverse events occurred in each group.The cost-effectiveness ratios were 15.04,9.91 respectively.Conclusions There was no significant difference in the total remission rate between the two groups after one week.The cost of NSAIDs group were the less,but the pain control effect in t he Multimodal analgesia group was significantly better than in NSAIDs group during the first two days after surgery.