術中雞尾酒療法對全膝關節置換術後疼痛及功能影響

Effect of intraoperative cocktail therapy on pain and function post total knee arthroplasty

目的回顧性研究術中使用雞尾酒療法對全膝關節置換術(Total Knee arthroplasty,TKA)後疼痛及功能的影響。方法2019年1月~2021年1月期間在本院進行TKA的患者納入研究。術中採用雞尾酒鎮痛療法者為治療組,未採用雞尾酒鎮痛療法者作為對照組。雞尾酒鎮痛療法具體實施方法:術中在膝關節周圍軟組織注射雞尾酒配方藥物,藥物組成為:Levobupivacaine Morphine adrenaline。分別觀察和記錄患者術後3天的VAS疼痛評分、膝關節伸直和屈曲活動度情況,比較兩組有無統計學差異。結果共有53例患者納入研究,治療組29例,平均年齡66.61±5.500歲;對照組23例;平均年齡66.60±4.903歲。治療組患者術後3天的VAS評分分別為:3.10±0.81,2.48±0.63及2.24±0.63,對照組術後3天分別為5.45±0.65,4.37±0.77及4.00±0.78,兩組比較有統計學差異(P<0.01)。在膝關節屈曲功能活動度方面,治療組術後3天分別為116.89°±11.90°,93.44°±12.61°及73.17°±13.01°,對照組術後3天分別為143.54°±8.53°,122.70°±8.72°及97.5°±8.96°,兩組比較有統計學差異(P<0.01)。兩組患者在膝關節伸直功能方面比較無明顯統計學差異。結論術中雞尾酒鎮痛療法能夠顯著減輕TKA患者的術後疼痛,有利於改善膝關節伸屈功能。

Objective To retrospectively study the effect of intraoperative cocktail therapy on pain and function after total knee arthroplasty(TKA).Methods Patients who underwent TKA at our hospital between January 2019 and January 2021 were included in the study.The patients who used cocktail analgesia during the operation were the treatment group,and those who did not use the cocktail analgesia were the control group.The specific implementation method of cocktail analgesia:the cocktail formulation was injected into the soft tissue around the knee joint during the operation,and the drug composition was:Levobupivacaine Morphine 4mg+adrenaline.Both groups received oral analgesia post operation,including.The VAS pain score,knee extension and flexion range of motion were observed and recorded 3 days post operation,comparing the two groups for statistical difference.Results A total of 53 patients were included in the study;29 in the treatment group,with an average age of 66.61±5.500 years,and 23 in the control group,with an average age of 66.60±4.903 years.The VAS scores 3 days after operation in the treatment group were:3.10±0.81,2.48±0.63,and 2.24±0.63,respectively,while those in the control group were 5.45±0.65,4.37±0.77,and 4.00±0.78 on the third day after the operation,respectively.There was a statistical difference between the two groups(P<0.01).In terms of the range of motion of knee flexion function,the treatment group was 116.89°±11.90°,93.44°±12.61°and 73.17°±13.01°3 days after the operation,and the control group was 143.54°±8.53°,122.70°±8.72°and 97.5°±8.96°3 days after the operation,respectively.There were significant differences between the two groups at°8.72°and 97.5°8.96°(P<0.01).There was no significant difference in knee extension function between the two groups of patients.Conclusion Intraoperative cocktail analgesia can significantly reduce postoperative pain in patients with TKA,which is beneficial in improving knee extension and flexion function.