酮咯酸氨丁三醇在全髋关节置换术后镇痛效果分析

The analgesic effects of ketorolac tromethamine for patients undergoing THA

目的研究酮咯酸氨丁三醇对全髋关节置换术后(total hip arthroplasty,THA)患者术后镇痛效果。方法前瞻性纳入2019年6月至2020年3月在三亚市人民医院全身麻醉下行THA患者80例为试验对象,依据随机数字表法将患者分为帕瑞昔布钠组(P组)和酮咯酸氨丁三醇组(K组),每组40例。术中均采用切口局部浸润,比较2组患者术后疼痛程度、吗啡用量;比较2组患者出院时的疼痛控制满意度、功能恢复满意度、关节活动度;比较2组患者术后并发症的发生率。结果K组患者在术后2、6、12 h静息VAS评分均低于P组(P<0.05);术后6、12 h活动VAS评分均低于P组(P<0.05);K组患者术后12 h内,术后12~24 h以及住院期间的吗啡总用量均低于P组(P<0.05)。K组患者的术后疼痛控制满意度高于P组(P<0.05),2组患者功能恢复满意度和髋关节活动度差异无统计学意义(P>0.05)。2组患者术后并发症发生率接近,差异无统计学意义(P>0.05)。结论在THA术后镇痛中应用酮咯酸氨丁三醇可有效的缓解术后疼痛,减轻阿片类药物的用量,同时用药安全性也较高,此镇痛方案值得借鉴推广。

Objective To investigate the analgesic effects of ketorolac tromethamine for patients after total hip replacement total hip arthroplasty(THA).Methods A total of 80 patients who underwent THA under general anaesthesia in our hospital from June 2019 to March 2020 were enrolled in the study,who were randomly divided into two groups,with 40 cases in each group.The patients in regroup P were treated by parecoxib sodium,however,those in group K were treated by ketorolac tromethamine,with local incision infiltration for both groups.The postoperative pain,morphine dosage,pain control,functional recovery and joint activity,and the incidence of postoperative complications were observed and compared between the two groups.Results The resting VAS scores at 2h,6h,12h after operation in group K were significantly lower than those in group P(P<0.05),and the active VAS scores at 6h,12h after operation in group K were significantly lower than those in group P(P<0.05).The total morphine consumption within 12~24h after operation and duration of hospital stay in group K were significantly lower than those in group P(P<0.05).Moreover the postoperative pain control satisfaction degree in group K was significantly higher than that in group P(P<0.05),however,there were no significant differences in functional recovery satisfaction degree and hip activity as well as the incidence of postoperative complications between the two groups(P>0.05).Conclusion The application of ketorolac tromethamine in THA postoperative analgesia can effectively relieve postoperative pain and decrease the dosage of opioid drugs,with higher medication safety,therefore,the analgesic scheme is worthy of clinical application and promotion.