Analgesic effects of cocktail therapy and patient automatic controlled epidural analgesia after total hip replacement
10.3760/cma.j.jssn.1673-4904.2016.04.017
- VernacularTitle:全髋关节置换术后患者自控硬膜外镇痛和鸡尾酒疗法的效果观察
- Author:
Li WEI
;
Jun TIAN
- Publication Type:Journal Article
- Keywords:
Arthroplasty;
replacement;
hip;
Analgesia;
epidural;
Cocktail therapy
- From:
Chinese Journal of Postgraduates of Medicine
2016;39(4):346-349
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss postoperative analgesia effect of patient automatic controlled epidural analgesia (PCEA) and cocktail therapy (CT) after total hip replacement. Methods Eighty-eighty patients of selective total hip replacement were selected, and the patients were divided into PCEA group and CT group by random digits table method with 44 cases each. The postoperative resting state and active state visual analogue score (VAS), dosage of opioid, discharge time, postoperative complications, postoperative sleep quality score and hip joint mobility were compared between 2 groups. Results The resting state and active state VAS in PCEA group 12, 24 and 48 h after operation were significantly lower than those in CT group, resting state: (3.68 ± 1.45) scores vs. (4.23 ± 1.14) scores, (2.61 ± 1.04) scores vs. (3.92 ± 1.23) scores and (2.31 ± 0.97) scores vs. (3.56 ± 1.21) scores, active state:(4.54 ± 1.63) scores vs. (5.87 ± 2.11) scores, (3.51 ± 0.94) scores vs. (4.34 ± 1.07) scores and (3.01 ± 0.95) scores vs. (4.05 ± 1.17) scores, and there were statistical differences (P<0.05). But there were no statistical differences in VAS 72 h after operation and at discharge between 2 groups (P>0.05). The dosage of opioid in PCEA group was significantly lower than that in CT group:(9.58 ± 5.35) mg vs. (11.27 ± 4.48) mg, and there was statistical difference (P<0.05). The incidences of nausea vomiting and headache dizziness in CT group were significantly lower than those in PCEA group: 20.45% (9/44) vs. 45.45% (20/44) and 4.55% (2/44) vs. 13.64% (6/44), and there were statistical differences (P<0.05). There were no statistical differences in length of hospital stay, postoperative sleep quality score and postoperative hip joint mobility between 2 groups (P>0.05). Conclusions Choice of analgesic regimen of choice should not be made only according to the length of hospital stay. Individualized treatment is recommended. According to specific circumstances and needs of patients, patients with less anesthetics and a tendency to nausea should use PCEA, and for chronic pain patients CT may be more effective.
