氟比洛芬联合罗哌卡因镇痛在老年全膝关节置换术患者中的应用研究

Application of flurbiprofen combined with ropivacaine in elderly patients undergoing total knee arthroplasty

目的观察氟比洛芬联合罗哌卡镇痛模式在老年膝关节置换术患者中的应用效果,为治疗该病症提供方法。方法纳入2019年10月—2021年3月在汕头市中心医院行膝关节置换术的62例老年患者,按数字表法随机分为观察组(n=31)与对照组(n=31)。对照组术后以舒芬太尼进行自控静脉镇痛,观察组以氟比洛芬联合罗哌卡因在术前、术中与术后进行镇痛。观察并比较2组术后疼痛程度、膝关节功能、相关血清标志物水平、认知功能及不良反应发生率。结果观察组术后24h和48h的VAS评分均显著低于对照组(P<0.001)。术后2周,观察组膝关节功能恢复显著优于对照组(P<0.001)。术后24h,观察组血清COR、NSE和IL-10水平显著低于对照组(P<0.001)。术后3d,观察组MMSE评分明显高于对照组(P<0.001)。2组不良反应总发生率差异无统计学意义(P> 0.05)。结论氟比洛芬联合罗哌卡因镇痛可显著降低老年全膝关节置换患者术后的疼痛程度,缓解应激反应,减轻手术对患者认知功能影响,利于患者膝关节功能恢复,安全性较好,具有一定的临床价值。

Objective To observe the effect of flurbiprofen combined with ropivacaine analgesia in elderly patients undergoing total knee arthroplasty,so as to provide a method for the treatment of this disease. Methods 62 elderly patients who underwent total knee arthroplasty in Shantou Central Hospital from October2019 to March2021 were included.They were randomly divided into observation group(n= 31)and control group(n= 31). The control group received patient-controlled intravenous analgesia with sufentanil after operation. The observation group was given flurbiprofen combined with ropivacaine for preoperative,intraoperative and postoperative analgesia. The postoperative pain degree,knee joint function,related serum marker levels,cognitive function and incidence of adverse reactions were observed and compared between the two groups. Results The VAS scores at24 and48 hours after operation of the observation group were significantly lower than those of the control group(P< 0.001). Two weeks after operation,the recovery of knee joint function of the observation group was significantly better than that of the control group(P< 0.001).24 hours after operation,the levels of serum COR,NSE and IL-10 of the observation group were significantly lower than those of the control group(P< 0.001). Three days after operation,the MMSE score of the observation group was significantly higher than that of the control group(P<0. 001). There was no significant difference in the total incidence of adverse reactions between the two groups(P> 0.05).Conclusion Flurbiprofen combined with ropivacaine analgesia can significantly reduce the postoperative pain of elderly patients undergoing total knee arthroplasty,alleviate stress response,reduce the impact of surgery on patients’ cognitive function,and facilitate the recovery of knee joint function. It is safe and has certain clinical value.