CAJ | 학술논문

目的：观察塞来昔布联合曲马多对膝关节表面置换术的超前镇痛疗效。方法将行膝关节表面置换术的90例随机分为A、B、C三组，术前2 d至禁食前分别口服盐酸曲马多缓释片50 mg、塞来昔布胶囊200 mg、塞来昔布胶囊100 mg＋盐酸曲马多缓释片25 mg，术后6 h分别口服盐酸曲马多缓释片50 mg、塞来昔布胶囊200 mg、塞来昔布胶囊100 mg＋盐酸曲马多缓释片25 mg，术后2 d分别口服盐酸曲马多缓释片50 mg/12 h、塞来昔布胶囊200 mg q12 h、塞来昔布胶囊100 mg＋盐酸曲马多缓释片25 mg/12 h；三组患者均于术后麻醉消失后行硬膜外镇痛（PCEA），观察比较三组患者术后8 h、24 h、36 h、48 h静息状态下疼痛和术后3晚睡眠的视觉模拟评分法（ VAS）评分、PCEA首次按压时间及术后48 h内按压次数、患者疼痛满意度、药物不良反应。结果 C组患者镇痛疗效、睡眠质量、疼痛满意度均显著优于A组、B组（P＜0．05），C组显著地提升镇痛效果。三组术后不良反应未见显著差异（P＞0．05）。结论围术期联合应用塞来昔布和曲马多可有效实现膝关节表面置换术的超前镇痛。
목적：관찰새래석포연합곡마다대슬관절표면치환술적초전진통료효。방법장행슬관절표면치환술적90례수궤분위A、B、C삼조，술전2 d지금식전분별구복염산곡마다완석편50 mg、새래석포효낭200 mg、새래석포효낭100 mg＋염산곡마다완석편25 mg，술후6 h분별구복염산곡마다완석편50 mg、새래석포효낭200 mg、새래석포효낭100 mg＋염산곡마다완석편25 mg，술후2 d분별구복염산곡마다완석편50 mg/12 h、새래석포효낭200 mg q12 h、새래석포효낭100 mg＋염산곡마다완석편25 mg/12 h；삼조환자균우술후마취소실후행경막외진통（PCEA），관찰비교삼조환자술후8 h、24 h、36 h、48 h정식상태하동통화술후3만수면적시각모의평분법（ VAS）평분、PCEA수차안압시간급술후48 h내안압차수、환자동통만의도、약물불량반응。결과 C조환자진통료효、수면질량、동통만의도균현저우우A조、B조（P＜0．05），C조현저지제승진통효과。삼조술후불량반응미견현저차이（P＞0．05）。결론위술기연합응용새래석포화곡마다가유효실현슬관절표면치환술적초전진통。
Objective To observe the efficacy of celecoxib combined tramadol in treatment of preemptive analgesia for total knee replacement surgery .Methods 90 patients undergoing total knee arthroplasty were randomly divided into three groups ,namely group A,group B,group C,before two days to fast oral tramadol hydrochloride sustained-release tablets 50 mg,celecoxib capsules 200 mg,plug celecoxib capsules 100 mg +tramadol hydrochloride sustained-release tablets 25 mg,respectively.After six hours of oral or gastric infusion of tramadol hydrochloride sustained-release tablets 50 mg, celecoxib capsules 200 mg, celecoxib capsules tramadol hydrochloride 100 mg +25 mg sustained-release tablets and after two days be tramadol hydrochloride sustained-release tablets 50 mg/12 h oral celecoxib capsules 200 mg/12 h oral celecoxib capsules 100 mg +tramadol hydrochloride sustained-release tablets 25 mg/12 h orally,three groups of patients disappeared underwent epidural analgesia (PCEA) in the postoperative anesthesia.Three groups of patients were observed and compared after 8 h,24 h,36 h,48 h resting under after three nights of sleep and pain VAS score , PCEA first press time and 48 h after pressing the number of patient satisfaction with pain ,adverse drug reactions .Results The patients in group C of analgesic efficacy,quality of sleep,pain,satisfaction were significantly better than in group A ,group B (P<0.05).The group C significantly enhanced the analgesic effect .Three groups had no significant difference in adverse events (P>0.05).Conclu-sion The combination of perioperative celecoxib and tramadol preemptive analgesia can effectively achieve full knee .