地西泮在全髋关节置换术后镇痛的应用

Application of Diazepam in Analgesia After Total Hip Arthroplasty

目的研究患者在全髋关节置换术后应用地西泮(睡前)对患者术后疼痛的改善作用。方法收集2016年1月至2020年2月在锦州医科大学附属第三医院骨科进行全髋关节置换手术患者64例,30例患者采用术后常规镇痛泵(A组),34例患者采用镇痛泵联合应用地西泮(B组)。两组患者分别于术后24、48和72 h时,视觉模拟评分法(VAS评分)评定患者下肢静止情况下VAS(RVAS)评分、被动屈髋时VAS(MVAS)评分、屈髋肌力、镇痛药追加情况和药物不良反应。结果B组术后各时间点的VAS(RVAS)评分、被动屈髋VAS(MVAS)评分均较A组低,差异有统计学意义(P<0.05);屈髋肌力、患者满意度评分较A组高,差异有统计学意义(P<0.05);镇痛药追加率较A组低,差异有统计学意义(P<0.05);患者药物不良反应发生率差异无统计学意义(P>0.05)。结论术后应用地西泮片可以辅助改善全髋关节置换的术后镇痛效果。

Objective To study the effect of diazepam on reducing postoperative pain after total hip arthroplasty.Methods A total of 64 patients who underwent total hip arthroplasty in the Third Affiliated Hospital of Jinzhou Medical University from January 2016 to February 2020 were collected.30 patients were treated with routine postoperative analgesia pump(Group A),while 34 patients were treated with analgesic pump combined with diazepam(Group B).At 24,48 and 72 hours after operation,VAS(RVAS)score,passive hip flexion VAS(MVAS)score,hip flexion strength,additional analgesics and adverse reactions were evaluated in the two groups.Results The RVAS and MVAS scores of Group B at all postoperative time points were lower than those of Group A,and the difference was statistically significant(P<0.05).The muscle strength of hip flexion and patient satisfaction degree in Group B were significantly higher than those in Group A(P<0.05).The addition rate of analgesics in Group B was significantly lower than that in Group A(P<0.05),but there was no significant difference in the incidence rate of drug adverse reactions(P>0.05).Conclusion Application of diazepam after operation can help to improve the postoperative analgesic effect of total hip arthroplasty.