The effect of preprcelecoxib on postoperative analgesia after total knee arthroplasty in patients with Kashin-Beck disease
10.3760/cma.j.cn231583-20191209-00348
- VernacularTitle:帕瑞昔布钠用于大骨节病患者全膝关节置换术术后镇痛的效果观察
- Author:
Kaiyan WANG
1
;
Wei SHAO
;
Wei WANG
Author Information
1. 烟台山医院麻醉科 264001
- From:
Chinese Journal of Endemiology
2020;39(4):289-293
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the analgesic effect of preprcelecoxib on total knee arthroplasty in patients with Kashin-Beck disease(KBD).Methods:Eighty-four patients with severe knee joint KBD who underwent total knee arthroplasty in our hospital from January 2017 to January 2019 were selected as the subject of study. The patients were randomly divided into control group ( n = 42) and observation group ( n = 42). The control group was not treated with any analgesia before operation. The observation group was given preemptive analgesia with preprcelecoxib, and patients were injected intravenously with 40 mg preprcelecoxib 30 min before anesthesia induction. The visual analogue score (VAS) score and number of pressing patient-controlled induce analgesia (PCIA) 30 min, 2 h, 4 h and 12 h after operation were compared between two groups. The Hospital for Special Surgery (HSS) score and stress response index [norepinephrine (NE), blood glucose (BG) and cortisol(Cor)] were compared between two groups before operation and 12 and 24 h after operation. And the incidence of adverse drug incidence was also compared between the two groups. Results:The VAS score of the two groups increased at first and then decreased. There was no significant difference in VAS scores between the two groups 30 min after operation ( P > 0.05). But 2, 4 and 12 h after operation, the VAS score in the observation group [(5.75 ± 0.27), (4.02 ± 0.85), (2.04 ± 0.23) points] were significantly lower than those in the control group [(7.34 ± 0.35), (5.96 ± 0.90), (3.89 ± 0.27) points, P < 0.05]. The HSS score increased over time between the two groups, but without significant difference before operation ( P > 0.05). And 12 and 24 h after operation, the HSS scores in the observation group [(53.19 ± 6.53), (75.18 ± 4.63) points] were significantly higher than those in the control group [(46.29 ± 6.37), (60.38 ± 5.29) points, P < 0.05]. The level of stress response index of the two groups increased with time. And 12 and 24 h after operation, the levels of NE [(325.94 ± 25.67), (397.63 ± 27.55) ng/L], BG [(5.38 ± 0.52), (5.41 ± 0.54) nmol/L] and Cor [(241.94 ± 14.18), (253.82 ± 14.65) mg/L] in the observation group were significantly lower than those in the control group [(387.28 ± 26.92), (437.84 ± 28.96) ng/L, (5.79 ± 0.43), (6.54 ± 0.52) nmol/L, (275.39 ± 13.72), (289.63 ± 13.95) mg/L, P < 0.05]. The number of PCIA pressing 24 h after operation in both groups was significantly higher than that 12 h after operation. The number of PCIA (4.62 ± 0.84, 8.38 ± 0.41) in the observation group was significantly lower than that in the control group (8.26 ± 0.65, 12.48 ± 0.73) 12 and 24 h after operation ( P < 0.05). The incidence of adverse reactions (19.05%, 8/42) in the observation group was significantly lower than that in the control group (52.38%, 22/42, P < 0.05). Conclusions:Preprcelecoxib can significantly reduce postoperative pain, reduce the expression of stress index, improve knee motion in a short period of time, reduce the number of pressing (PCIA) and the incidence of adverse drug reactions in patients with severe KBD of knee joint.
