元胡止痛滴丸超前镇痛在膝关节置换术中的临床应用

Clinical Application of Preemptive Analgesia with Yuanhu Zhitong Dropping Pills in Knee Arthroplasty

目的:探讨元胡止痛滴丸超前镇痛在膝关节置换术中的临床应用效果。方法:选取2020年9月—2023年9月上饶市人民医院收治的70例拟行全麻下单侧膝关节置换术患者,依据随机数字表法将其分为止痛丸组和常规组,各35例。止痛丸组术前2 h服用元胡止痛滴丸,常规组术前不服用药物,均予以气管插管全身麻醉+术后患者自控静脉镇痛(PCIA)镇痛。对比两组患者入室(T_(0))、气管插管(T_(1))、手术切皮(T_(2))、胫骨近端水平截骨(T_(3))、安装假体(T_(4))及术毕(T_(5))时的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))水平变化,对比两组麻醉情况,术后6、12、24 h静息、活动状态下疼痛[视觉模拟评分法(VAS)]评分,并比较两组的不良反应发生情况。结果:两组MAP、HR的组间、时间及交互差异均有统计学意义(P<0.05);T_(1)、T_(2)、T_(3)、T_(4),止痛丸组MAP、HR水平均低于常规组(P<0.05);两组SpO2组间、时间、交互差异均无统计学意义(P>0.05)。两组呼吸恢复时间、气管拔除时间比较,差异均无统计学意义(P>0.05)。止痛丸组术后镇痛泵追加次数少于常规组(P<0.05)。止痛丸组和常规组不良反应发生率(8.57%vs 17.14%)比较,差异无统计学意义(P>0.05)。结论:元胡止痛滴丸用于膝关节置换术患者镇痛治疗中,可利于患者围麻醉期血流动力学稳定,加强术后短期镇痛效果,安全有效。

Objective:To explore the clinical application effect of Yuanhu Zhitong Dropping Pills for preemptive analgesia during knee arthroplasty.Method:A total of 70 patients who were scheduled to undergo unilateral knee arthroplasty under general anesthesia in Shangrao People's Hospital were selected from September 2020 to September 2023.By means of the random number table method,they were classified into Zhitong pill group and conventional group with 35 cases in each group.The Zhitong pill group took Yuanhu Zhitong Dropping Pills at 2 hours before surgery,while the conventional group did not take drugs before surgery.All patients were given tracheal intubation general anesthesia+postoperative patient-controlled intravenous analgesia(PCIA).The changes in mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SpO_(2))at the time of admission(T_(0)),tracheal intubation(T_(1)),surgical skin incision(T_(2)),proximal tibial horizontal osteotomy(T_(3))and prosthesis installation(T_(4))and at the end of surgery(T_(5)),anesthesia status,pain[visual analogue scale(VAS)]score in resting state and active state at 6,12,24 h after surgery and occurrence of adverse reactions were compared between groups.Result:The differences of MAP and HR between the two groups,time and interaction were statistically significant(P<0.05);T_(1),T_(2),T_(3),T_(4),the levels of MAP and HR in Zhitong pill group were lower than those in conventional group(P<0.05);there were no significant differences in SpO2 between the two groups,time and interaction(P>0.05).There were no significant differences in respiratory recovery time and tracheal extraction time between the two groups(P>0.05).The number of postoperative analgesic pump supplementation in Zhitong pill group was less than that in conventional group(P<0.05).There was no significant difference in the incidence of adverse reactions(8.57%vs 17.14%)between the Zhitong pill group and the conventional group(P>0.05).Conclusion:Yuanhu Zhitong Dropping Pills can be used in the analgesia treatment of patients undergoing knee arthroplasty,which can be beneficial to the stability of hemodynamics during perioperative anesthesia period,and can strengthen the short-term analgesic effect after surgery,thus it is safe and effective.