丁丙诺啡透皮贴剂对膝关节置换术后疼痛的影响评估
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摘要
目的:探讨丁丙诺啡透皮贴剂在初次全膝关节置换术(TKA)术后镇痛方面的作用,优化TKA术后疼痛管理方案。方法:选取2017年3月—2017年11月我科收治的初次全膝关节置换手术患者58例,按术后镇痛治疗方案的不同分为A组(28例)和S组(30例);A组给予丁丙诺啡透皮贴剂(5 mg,每贴7天)治疗,S组采用塞来昔布胶囊(200 mg,bid)治疗。根据疼痛数字分级评估法比较两组术后2天、7天、14天、1月、2月疼痛评分,胃肠道不适情况及术后依从性。结果:A组术后第14天、1月、2月疼痛评分低于S组,差异有统计学意义(P <0.05);A组不良反应发生率显著低于S组,差异有统计学意义(P <0.05);A组漏贴、漏服发生率明显低于S组,差异有统计学意义(P <0.05)。结论:丁丙诺啡透皮贴剂治疗人工膝关节置换术后慢性疼痛的镇痛效果更优,且使用方便,患者依从性高。
Objective: To investigate the roles of buprenorphine transdermal patch in postoperative analgesia after total knee arthroplasty(TKA) and to optimize pain management schemes after TKA. Methods: 58 patients with primary total knee arthroplasty admitted to our department from March 2017 to November 2017 were selected and divided into group A(28 cases) and group S(30 cases) according to different postoperative analgesic treatment regimens. The patients in the group A were given buprenorphine transdermal patches(5 mg, 7 days per patch), and the patients in the group S were treated with celecoxib capsules(200 mg, bid). Pain scores, gastrointestinal discomfort and postoperative compliance were compared between the two groups according to the pain digital grading assessment method 2 days, 7 days, 14 days, 1 month and 2 months after operation. Results: The pain scores in the group A were lower than those in the group S on the 14 th day and in the 1 st and 2 nd month after surgery, with statistically significant difference(P<0.05), and the incidence of adverse reactions in the group A was significantly lower than that in the group S, with statistically significant difference(P<0.05). The incidence of missed sticking and missed taking in the group A was significantly lower than that in the group S, with statistically significant difference(P<0.05). Conclusion: The buprenorphine transdermal patch has better effect on chronic pain after artificial knee arthroplasty, and is easy to use, and its patient compliance is high.
Objective: To investigate the roles of buprenorphine transdermal patch in postoperative analgesia after total knee arthroplasty(TKA) and to optimize pain management schemes after TKA. Methods: 58 patients with primary total knee arthroplasty admitted to our department from March 2017 to November 2017 were selected and divided into group A(28 cases) and group S(30 cases) according to different postoperative analgesic treatment regimens. The patients in the group A were given buprenorphine transdermal patches(5 mg, 7 days per patch), and the patients in the group S were treated with celecoxib capsules(200 mg, bid). Pain scores, gastrointestinal discomfort and postoperative compliance were compared between the two groups according to the pain digital grading assessment method 2 days, 7 days, 14 days, 1 month and 2 months after operation. Results: The pain scores in the group A were lower than those in the group S on the 14 th day and in the 1 st and 2 nd month after surgery, with statistically significant difference(P<0.05), and the incidence of adverse reactions in the group A was significantly lower than that in the group S, with statistically significant difference(P<0.05). The incidence of missed sticking and missed taking in the group A was significantly lower than that in the group S, with statistically significant difference(P<0.05). Conclusion: The buprenorphine transdermal patch has better effect on chronic pain after artificial knee arthroplasty, and is easy to use, and its patient compliance is high.
引文
[1]潘京华,查振刚.初次膝关节置换术后膝部疼痛原因分析及处理方法[J].中华关节外科杂志(电子版),2015,9(2):252-256.
[2]任晓凤,任娜娜,张爱文,等.丁丙诺啡透皮贴剂的缓释镇痛作用[J].中国组织工程研究,2015,19(21):3339-3343.
[3]高国伟,刘朝晖,张启栋,等.丁丙诺啡透皮贴剂与病人控制镇痛在全膝关节置换术后有效性和安全性比较观察[J].临床医药文献电子杂志,2017,4(32):6271,6274.
[4]王家双,潘胜发.ACHEON调查中国慢性非癌痛镇痛治疗及阿片类药物使用现状分析[J].中国医师杂,2016,18(4):492-496.
[5]詹鹏,赵畅,蔡道章,等.丁丙诺啡透皮贴剂在人工膝关节置换术后的镇痛效果[J].广东医学,2017,38(z1):229-231.
[6]彭印文,陈棉智,崔邦胜.丁丙诺啡透皮贴剂对全膝关节置换术后镇痛的疗效观察[J].赣南医学院学报,2016,36(3):392-395.
[7]马欢欢,陈慧娟,花嵘,等.不良生活习性对慢性非癌性疼痛发病率与治疗效果的影响[J].国际麻醉学与复苏杂志,2013,34(12):1098-1101,1108.
[8]陈焰,张阳春,余世明.丁丙诺啡透皮贴用于骨科大手术术后镇痛的效果[J].广东医学,2015,36(19):3056-3058.
[2]任晓凤,任娜娜,张爱文,等.丁丙诺啡透皮贴剂的缓释镇痛作用[J].中国组织工程研究,2015,19(21):3339-3343.
[3]高国伟,刘朝晖,张启栋,等.丁丙诺啡透皮贴剂与病人控制镇痛在全膝关节置换术后有效性和安全性比较观察[J].临床医药文献电子杂志,2017,4(32):6271,6274.
[4]王家双,潘胜发.ACHEON调查中国慢性非癌痛镇痛治疗及阿片类药物使用现状分析[J].中国医师杂,2016,18(4):492-496.
[5]詹鹏,赵畅,蔡道章,等.丁丙诺啡透皮贴剂在人工膝关节置换术后的镇痛效果[J].广东医学,2017,38(z1):229-231.
[6]彭印文,陈棉智,崔邦胜.丁丙诺啡透皮贴剂对全膝关节置换术后镇痛的疗效观察[J].赣南医学院学报,2016,36(3):392-395.
[7]马欢欢,陈慧娟,花嵘,等.不良生活习性对慢性非癌性疼痛发病率与治疗效果的影响[J].国际麻醉学与复苏杂志,2013,34(12):1098-1101,1108.
[8]陈焰,张阳春,余世明.丁丙诺啡透皮贴用于骨科大手术术后镇痛的效果[J].广东医学,2015,36(19):3056-3058.