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普瑞巴林联合塞来昔布用于全膝关节置换术的超前镇痛效果:一项前瞻性对照随机研究。

Positive Preemptive Analgesia Effectiveness of Pregabalin Combined with Celecoxib in Total Knee Arthroplasty: A Prospective Controlled Randomized Study.

机构信息

The Department of Orthopaedics, The Jian Yang Hospital of Traditional Chinese Medicine, Jianyang 641400, China.

The Department of Orthopaedics, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi City), Zunyi 563000, China.

出版信息

Pain Res Manag. 2023 Jan 12;2023:7088004. doi: 10.1155/2023/7088004. eCollection 2023.

Abstract

OBJECTIVE

The purpose of the present study (a randomized clinical trial) was to evaluate the preemptive analgesic effects of pregabalin combined with celecoxib in total knee arthroplasty (TKA).

METHODS

From January 2019 to June 2021, we enrolled 149 patients who underwent TKA and divided them into four groups: the placebo group ( = 36), celecoxib group ( = 38), pregabalin group ( = 38), and combination group ( = 37). Each group was given the corresponding preemptive analgesia regimen at 12 and 2 hours before surgery. The pain score at rest and upon movement, cumulative dosage of sufentanil, knee range of motion (ROM), high-sensitivityC-reactive protein (hs-CRP) level, and adverse effects were evaluated after TKA to compare the effects of the preemptive analgesia regimens among the four groups.

RESULTS

The pain scores upon movement were significantly lower in the combination group than in the other three groups at 6, 12, 24, and 48 hours after surgery ( < 0.05). The cumulative dose of sufentanil within 48 hours after surgery was lowest in the combined group among the four groups ( < 0.05). Hs-CRP, ROM, and postoperative nausea and vomiting (PONV) were within 72 hours after surgery significantly improved in the combination group compared with those of the three other groups ( < 0.05).

CONCLUSION

The preemptive analgesia regimen of pregabalin combined with celecoxib had positive effects on improving acute pain and reducing the cumulative dose of opioids after TKA. This trial is registered with ChiCTR2100041595.

摘要

目的

本研究(一项随机临床试验)旨在评估普瑞巴林联合塞来昔布在全膝关节置换术(TKA)中的超前镇痛效果。

方法

2019 年 1 月至 2021 年 6 月,我们纳入了 149 例行 TKA 的患者,并将其分为四组:安慰剂组(n=36)、塞来昔布组(n=38)、普瑞巴林组(n=38)和联合组(n=37)。每组在手术前 12 小时和 2 小时给予相应的超前镇痛方案。在 TKA 后评估静息和运动时的疼痛评分、舒芬太尼累积剂量、膝关节活动度(ROM)、高敏 C 反应蛋白(hs-CRP)水平和不良反应,以比较四组超前镇痛方案的效果。

结果

术后 6、12、24 和 48 小时,运动时的疼痛评分在联合组明显低于其他三组(<0.05)。四组中,联合组术后 48 小时内舒芬太尼累积剂量最低(<0.05)。联合组术后 72 小时内 hs-CRP、ROM 和术后恶心呕吐(PONV)明显改善,优于其他三组(<0.05)。

结论

普瑞巴林联合塞来昔布的超前镇痛方案对改善 TKA 后急性疼痛和减少阿片类药物累积剂量有积极作用。本试验已在中国临床试验注册中心注册,注册号为 ChiCTR2100041595。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e9a/9851777/f50d2f678109/PRM2023-7088004.001.jpg

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