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新型长效口服阿片类镇痛方案用于全髋关节和膝关节置换术后疼痛控制的前瞻性分析。

Prospective analysis of a novel long-acting oral opioid analgesic regimen for pain control after total hip and knee arthroplasty.

作者信息

Illgen Richard L, Pellino Teresa A, Gordon Debra B, Butts Sheryl, Heiner John P

机构信息

Department of Orthopedics and Rehabilitation, University of Wisconsin Madison, Madison, Wisconsin 53792, USA.

出版信息

J Arthroplasty. 2006 Sep;21(6):814-20. doi: 10.1016/j.arth.2005.10.011.

Abstract

Parenteral opioid use after total knee (TKA) and hip (THA) arthroplasty often results in substantial functional interference and side effects. This prospective study compared use of traditional intravenous patient-controlled analgesia (IV PCA) with a novel oral regimen after TKA and THA. Sixty-two patients received IV PCA and 62 received scheduled long-acting and, as needed, short-acting oral opioids postoperatively. Surveys and chart audits documented functional interference, pain scores, opioid-related side effects, and opioid consumption. Patients who received the oral regimen had significantly less opioid consumption (P < .05) and experienced less functional interference (P < .05) than the IV PCA group. Both groups had similar pain scores and incidence of opioid side effects. This study demonstrates some significant advantages of an oral analgesic regimen compared with IV PCA after TKA and THA.

摘要

全膝关节置换术(TKA)和全髋关节置换术(THA)后胃肠外使用阿片类药物常常导致严重的功能障碍和副作用。这项前瞻性研究比较了全膝关节置换术和全髋关节置换术后传统静脉自控镇痛(IV PCA)与新型口服方案的使用情况。62例患者接受静脉自控镇痛,62例患者术后接受定期长效及必要时短效口服阿片类药物治疗。调查和图表审核记录了功能障碍、疼痛评分、阿片类药物相关副作用及阿片类药物消耗量。接受口服方案的患者与静脉自控镇痛组相比,阿片类药物消耗量显著减少(P < .05),功能障碍也较少(P < .05)。两组的疼痛评分和阿片类药物副作用发生率相似。本研究表明,与全膝关节置换术和全髋关节置换术后静脉自控镇痛相比,口服镇痛方案具有一些显著优势。

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