Wang Jiangjing, Wei Shunyi, Ao Yingfang, Yang Yuping
Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province, Cangzhou 061001, Hebei, China.
Hebei Key Laboratory of Integrated Traditional and Western Medicine in Osteoarthrosis Research (Pre-paring), Cangzhou 061001, Hebei, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2024 Apr 18;56(2):293-298. doi: 10.19723/j.issn.1671-167X.2024.02.014.
The pain-relieving effect and safety of compound aminopyrine phenacetin tablets, tramcontin (tramadol hydrochloride sustained-release tablets) and dolantin in the early stage of autologous tendon reconstruction of the anterior cruciate ligament (ACL) of the knee joint were compared.
Retrospective analysis of postoperative pain and drug analgesia in 45 patients performed by the same group from November 2018 to February 2019. The random area group design was divided into two groups according to whether ACL rupture was combined with meniscal injury, group A was 24 patients with ACL reconstruction of knee joint and group B was 21 patients with ACL fracture combined with meniscus injury. The two groups were divided into three subgroups respectively according to the actual treatment of postoperative analgesic drugs received by the patients, including 4 cases of compound aminopyrine phenacetin tablets, 11 cases of oral tramcontin, 9 cases of intramuscular dolantin combined with phenergan in group A; 3 cases of compound aminopyrine phenacetin tablets, 10 cases of oral tramcontin, and 8 cases of intramuscular dolantin combined with phenergan in group B. When the early postoperative patients complain about pain and actively ask for analgesia. When the patients complained about pain after the operation and actively asked for analgesia, they were randomly given painkillers, tramcontin or dolantin combined with phenergan to relieve pain. Pain visual analogue scale (VAS) was used to evaluate pain relief and observe the occurrence of adverse reactions.
There were no significant dif-ferences in gender, age, body mass index, and time of hospital stay between the two groups of patients ( > 0.05). In the patients who used tramcontin and dolantin combined with phenergan to relieve pain judging by VAS score before and 1 h after taking the drug, it was found that the pain situation of the patient was significantly relieved, and the difference before and after taking the drug had statistical significance ( < 0.05). Pairwise comparisons of the three drugs applied in the two groups showed significantly greater pain relief in the dolantin combined with phenergan group than in the remaining two drugs. There was no significant difference ( > 0.05). Dolantin was prone to nausea and vomiting, but the application of phenergan was also used to reduce side effects. In terms of adverse reactions, only 1 case of nausea occurred in the tramcontin group for simple ACL reconstruction, and none of the patients in the other groups showed serious complications and allergic reactions.
Whether in cruciate ligament reconstruction alone or combined with meniscus molding or suture, compound aminopyrine phenacetin tablets, tramcontin, dolantin combined with phenergan can effectively relieve pain. Among the three drugs, dolantin caused the largest pain relief. At the same time, the combination of phenergan effectively reduced the adverse reactions, such as vomiting and nausea, and increased the drug safety.
比较复方氨基比林非那西丁片、曲马多缓释片（曲马多盐酸盐缓释片）和杜冷丁在膝关节前交叉韧带（ACL）自体肌腱重建早期的止痛效果及安全性。
回顾性分析2018年11月至2019年2月同一组对45例患者术后疼痛及药物镇痛情况。采用随机区组设计，根据ACL断裂是否合并半月板损伤分为两组，A组为24例膝关节ACL重建患者，B组为21例ACL断裂合并半月板损伤患者。两组再根据患者实际接受的术后镇痛药治疗情况分别分为三个亚组，A组中复方氨基比林非那西丁片4例、口服曲马多缓释片11例、杜冷丁联合非那根肌肉注射9例；B组中复方氨基比林非那西丁片3例、口服曲马多缓释片10例、杜冷丁联合非那根肌肉注射8例。术后早期患者主诉疼痛并主动要求镇痛时，随机给予止痛药、曲马多缓释片或杜冷丁联合非那根以缓解疼痛。采用疼痛视觉模拟评分法（VAS）评估疼痛缓解情况并观察不良反应的发生。
两组患者在性别、年龄、体重指数及住院时间方面差异无统计学意义（P>0.05）。从用药前及用药后1小时的VAS评分判断，使用曲马多缓释片和杜冷丁联合非那根缓解疼痛的患者，疼痛情况明显缓解，用药前后差异有统计学意义（P<0.05）。两组应用的三种药物两两比较显示，杜冷丁联合非那根组的疼痛缓解程度明显大于其余两种药物，差异无统计学意义（P>0.05）。杜冷丁易出现恶心、呕吐，但应用非那根也可减轻副作用。在不良反应方面，单纯ACL重建的曲马多缓释片组仅1例出现恶心，其他组患者均未出现严重并发症及过敏反应。
无论是单纯交叉韧带重建还是合并半月板成型或缝合，复方氨基比林非那西丁片、曲马多缓释片、杜冷丁联合非那根均能有效缓解疼痛。三种药物中，杜冷丁止痛效果最佳。同时，非那根的联合应用有效减少了呕吐、恶心等不良反应，提高了用药安全性。
