Standardized analgesic in total knee arthroplasty perioperative application
10.3760/cma.j.issn.1008-6706.2016.01.032
- VernacularTitle:规范化镇痛在全膝关节置换术围术期中的应用
- Author:
Shaoqu TIAN
;
Ye TIAN
- Publication Type:Journal Article
- Keywords:
Joint replacemet knee;
anesthesia and analgesia;
targeting analgesia
- From:
Chinese Journal of Primary Medicine and Pharmacy
2016;(1):117-121
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the standardization of analgesia in total knee replacement (TKA),and to assess its efficacy and safety of perioperative period application.Methods 64 cases of total knee arthroplasty cases were selected,with 30 cases of male,and 34 cases of female(Aged 61 -78),included 28 cases on the left side,and 36 cases on the right side.According to the random of prefabricated CARDS (1 :1 parallel design of experiment) patients were divided into observation group and control group,with 32 cases in each group(17 cases were women, 15 cases were male,).The observation group were treated with standardized analgesia,the control group were treated with traditional postoperative controlled intravenous analgesia (PCIA)pump.48 h after surgery,the different time points after waking up general anesthesia visual analogue scale (VAS),giving pain sleepers auxiliary analgesic drug application were recorded.VAS score and analgesic drug usage and complications (nausea,vomiting,respiratory depression,motor nerve paralysis,etc.)incidence index etc.of the two groups of patients were compared.Results 64 patients were included in the study,the differences of the two groups of patients in age [observation group:(68.22 ± 0.18),the control group:(69.69 ±0.17),t =5.767,P =0.8237)],gender(15 cases were men,17 cases were women),body mass index [BMI,observation group:(23.38 ±0.19),the control group:(23.94 ±0.14),t =2.339, P =0.082)],the American society of anesthesiologists (ASA)classification (both for 10 cases of ASA grade I,ASA grade II 22 cases),had no statistical significance (P >0.05).And different time points after surgery anesthesia to VAS score had significant difference:[(control group:6 h resting 2.888 ±0.049 /ankle pumps 2.941 ±0.028,12h resting 4.731 ±0.028 /ankle pump 5.747 ±0.033,24h resting 6.859 ±0.033 /ankle pump 7.175 ±0.03,48h resting 4.14 ±0.03 /ankle pumps 5.209 ±0.025.observation group:6h resting 1.316 ±0.024/ankle pumps 1.884 ± 0.023,12h resting 2.05 ±0.02 /ankle pump 3.060 ±0.02,24h resting 2.35 ±0.02 /ankle pump 3.934 ±0.018, 48h resting 2.119 ±0.015 /ankle pumps 2.317 ±0.017.t value resting/ankle pump:6h,17.80 /28.75.12h,76.67 /69. 14.24h,116.9 /91.95.48h,61.11 /95.51.P <0.01)].Analgesic drug usage (control:55.97 ±0.25,the observation group:19.53 ±0.19,t =113.1,P <0.01),the incidence of complications (control:0.45 ±0.00,observation group:0.06 ±0.00;t =169,P <0.01 ),and other aspects of the differences were statistically significant (P <0.05 ). Conclusion Standardized analgesia on the perioperative analgesic effects of total knee arthroplasty is better than PCIA.It can significantly reduce the extra analgesic drug usage,decrease the incidence of complications,and has the characteristics of safe and efficient.
