多模式镇痛在交锁髓内钉治疗胫骨骨折围术期的应用

Application of Multimodal Analgesia in Perioperative Pain Control of Interlocking Intramedullary Nailing in the Treatment of Tibial Fracture

目的探究多模式镇痛在交锁髓内钉治疗胫骨骨折围术期的应用价值。方法选取2020年1月—2021年4月本院收治的接受交锁髓内钉治疗的胫骨骨折患者74例,随机分为两组,观察组38例采用多模式镇痛,对照组36例采用传统镇痛,比较两组患者术后静息、运动状态下的VAS评分,膝关节活动度,主被动屈曲膝关节达90°所需时间及不良反应发生率。结果术后第1、3、7天在静息及活动状态下VAS评分,多模式镇痛组低于传统镇痛组(P<0.05)。术后第1、3、7天膝关节活动度,多模式镇痛组优于传统镇痛组(P<0.05)。多模式镇痛组患者膝关节主、被动屈曲至90°所需时间均早于传统镇痛组(P<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论在交锁髓内钉治疗胫骨骨折的围术期应用多模式镇痛理念,可有效减轻膝关节疼痛,增加膝关节活动度,临床应用效果满意。

Objective To investigate the value of multimodal analgesia in the treatment of tibial fracture with interlocking intramedullary nailing.Methods A total of 74 cases with tibial fracture in our hospital from January 2020 to April 2021 performed interlocking intramedullary nailing randomized to two groups.38 cases in the observation group were treated with multimodal analgesia,36 cases in the control group were treated with traditional analgesia.The main evaluation indicators included VAS scores at rest and in motion after operation,range of motion,the time needed of active and passive flexion of knee joint reached 90°and incidence of related complications.Results The VAS scores at rest and in motion at 1 day,3 days and 7 days after operation in group with multimodal analgesia was lower than those in group with traditional analgesia(P<0.05).Range of motion at 1 day,3 days and 7 days after operation in group with multimodal analgesia was superior to that in group with traditional analgesia(P<0.05).The time required of active and passive flexion of knee joint reached 90°in group with multimodal analgesia was earlier than group with traditional analgesia(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Multimodal analgesia in the treatment of tibial fracture could reduce the pain of knee joint,increase the range of motion,the clinical application effect is satisfactory.