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首页> 外文期刊>Journal of International Medical Research >Efficacy of a Multimodal Analgesia Protocol in Total Knee Arthroplasty: A Randomized, Controlled Trial
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Efficacy of a Multimodal Analgesia Protocol in Total Knee Arthroplasty: A Randomized, Controlled Trial

机译：多模式镇痛方案在全膝关节置换术中的功效：随机对照试验。

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A total of 100 osteoarthritis patients undergoing unilateral total knee arthroplasty were randomly assigned to receive either a multimodal analgesia protocol, comprising oral celecoxib and tramadol before and after surgery and intra-articular injection of large doses of morphine, ropivacaine, adrenaline and betamethasone during surgery (trial group), or oral and intra-articular placebo (control group). All patients received patient-controlled analgesia for 48 h after surgery. Morphine consumption up to 48 h after surgery was significantly lower in the trial than in the control group. Compared with the control group, the trial group had significantly lower visual analogue scale (VAS) scores for pain at rest from 6 h to 7 days after surgery and significantly lower VAS scores during activity from 24 h to 7 days after surgery. Active straight leg raise and active 90° knee flexion were achieved sooner and range of knee movement at postoperative days 1–15 were significantly greater in the trial group. Postoperative wound healing, infection, blood pressure, heart rate, rash, respiratory depression, urinary retention and deep vein thrombosis were similar in the two groups, but nausea and vomiting were significantly less frequent in the trial group.
机译：总共100例接受单侧全膝关节置换术的骨关节炎患者被随机分配接受多模式镇痛方案，包括在手术前后口服塞来昔布和曲马多，以及在手术期间关节内注射大剂量吗啡，罗哌卡因，肾上腺素和倍他米松（试验组）或口服和关节内安慰剂（对照组）。所有患者均在手术后48小时接受了患者自控镇痛。试验后长达48小时的吗啡消耗量显着低于对照组。与对照组相比，试验组在术后6小时至7天的休息时疼痛的视觉模拟量表（VAS）评分显着降低，而在术后24小时至7天的活动期间的VAS评分显着降低。在试验组中，较早地实现了主动的直腿抬高和主动的90°屈膝，并且术后1-15天的膝盖运动范围明显更大。两组的术后伤口愈合，感染，血压，心率，皮疹，呼吸抑制，尿retention留和深静脉血栓形成相似，但试验组的恶心和呕吐发生率明显降低。

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