术后早期加倍服用艾瑞昔布可以提高全膝关节置换术后疼痛疗效及活动范围

Double Use of Imrecoxib Early after Operation Can Improve the Pain Efficacy and Range of Motion after Total Knee Arthroplasty

摘要: 目的：研究早期加倍应用艾瑞昔布用于全膝关节置换术(total knee arthroplasty, TKA)围手术期镇痛的临床效果。方法：随机选取100例接受TKA的患者，分为实验组和对照组，每组50例，实验组患者在TKA治疗2小时后接受400 mg艾瑞昔布，6小时以后再接受200 mg艾瑞昔布，以后每日接受200 mg/Bid艾瑞昔布直至术后第5天。对照组患者术后第二天上午9点摘除镇痛泵后每日服用200 mg/Bid艾瑞昔布直至术后第5天。两组患者均接受芬太尼患者自控镇痛。主要的结果测量是TKA治疗后第1至5天患者报告的视觉模拟量表疼痛评分。次要结果指标是术后第2天和第5天评估膝关节活动范围，芬太尼的总消耗量，术后发生不良反应的次数以及术前和术后的CRP。结果：与对照组相比，实验组在术后第1天和第2天的VAS疼痛评分中值明显较低，并且实验组在术后第2天的活动范围较好。结论：全膝关节置换术后早期加倍使用艾瑞昔布，不仅缓解术后早期疼痛、而且能够降低术后早期炎症反应，提高膝关节活动范围，提升患者术后早期满意度。

Abstract: Objective: To explore the clinical effect of early double application of Imrecoxib for perioperative analgesia during total knee arthroplasty (TKA). Methods: A total of 100 patients who were candi-dates of unilateral TKA were enrolled into this prospective study and randomly divided into the experimental group and the control group. Patients in the experimental group received 400 mg Imrecoxib 2 hours after TKA treatment, 200 mg Imrecoxib 6 hours after TKA treatment, and 200 mg/Bid Imrecoxib daily until the 5th postoperative day. The control group received 200 mg/Bid imrecoxib daily until the 5th day after the analgesic pump was removed at 9:00 a.m. on the 2nd day after surgery. Both groups received fentanyl patient-controlled analgesia. The primary outcome measure was the visual analog Scale pain score reported by patients on days 1 to 5 after TKA treatment. Secondary outcome measures were the assessment of knee range of motion on days 2 and 5 postoperatively, total fentanyl consumption, number of postoperative adverse reactions, and CRP before and after surgery. Results: Compared with the control group, the VAS pain score of the experimental group was significantly lower on the 1st and 2nd postoperative day, and the range of activity of the experimental group was better on the 2nd postoperative day. Conclusion: Double use of imrecoxib early after total knee replacement can not only relieve early postoperative pain, but also reduce early postoperative inflammatory reaction, improve the range of knee motion, and im-prove patients’ early postoperative satisfaction.