塞来昔布对前交叉韧带重建术超前镇痛疗效观察

Preemptive analgesic effect of celecoxib on anterior cruciate ligament reconstruction

目的:评价术前口服塞来昔布超前镇痛对关节镜下行前交叉韧带重建术后疼痛的影响。方法:选择2016年10月-2018年4月在我院关节镜下行前交叉韧带重建患者60例,随机分为对照组和试验组。试验组术前3d予塞来昔布胶囊口服,对照组术前不使用任何止痛药物,术毕两组患者均在手术室立即接入自控静脉镇痛泵和口服塞来昔布胶囊止痛治疗。镇痛泵组方为:曲马多注射液500mg,地佐辛注射液20mg,昂丹司琼4mg及0.9%氯化钠注射液100mL,流速为2mL/h持续泵入,疼痛不适可按压增加流速,可维持48h,术后48h拆除。观察并记录两组患者手术后6h(T6)、12h(T12)、24h(T24)、48h(T48)、72h(T72)的疼痛视觉模拟评分(VAS评分),术后镇痛泵按压次数。结果:试验组术后6h(T6)、12h(T12)、24h(T24)、48h(T48)、72h(T72)的VAS评分、术后镇痛泵按压次数少于对照组,差异具有统计学意义(P<0.05)。结论:对关节镜下行前交叉韧带重建患者,术前应用塞来昔布可有效实现超前镇痛,值得临床应用推广。

Objective:To evaluate the effect of preoperative preemptive analgesia on postoperative pain of arthroscopic anterior cruciate ligament reconstruction.Methods:60 patients with anterior cruciate ligament reconstruction from October 2016 to April 2018 were randomly divided into control group and experimental group.In the experimental group,the Preoperative 3d was taken orally by Celecoxib capsule,the control group did not use any analgesic drugs before operation,and both groups were immediately connected to the patient-controlled intravenous analgesia pump and the oral tamponade capsule analgesic treatment in the operation room.Analgesic pump group:tramadol injection 500mg,digoxin injection 20mg,ondansetron,0.9%sodium chloride injection 100ml,flow rate for 2ml/h continuous pump,pain discomfort can be pressed to increase the flow rate,can maintain 48h,after the removal of 48h after the operation.The pain Visual analogue score(VAS score)of 6 h(T6),12 h(T12),24 h(T24),48 h(T48),72 h(T72)and postoperative analgesia pump were observed and recorded in two groups of patients after operation.Results:The VAS score of 6 h(T6),12 h(T12),24 h(T24),48 h(T48),72 h(T72)and postoperative analgesia pump were less than those in the control group after operation,the difference was statistically significant(P<0.05).Conclusion:preoperative use of celecoxib can effectively realize preemptive analgesia in patients with anterior cruciate ligament reconstruction,and it is worth popularizing in clinical application.