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塞来昔布在膝关节镜手术患者中早期开始术前镇痛的疗效和安全性:一项随机对照研究。

The efficacy and safety of early initiation of preoperative analgesia with celecoxib in patients underwent arthroscopic knee surgery: A randomized, controlled study.

作者信息

Zhou Fanglun, Du Yingxun, Huang Weichun, Shan Junbiao, Xu Guohong

机构信息

Department of Orthopedics, Dongyang People's Hospital, Wenzhou Medical University, Dongyang, Zhejiang, China.

出版信息

Medicine (Baltimore). 2017 Oct;96(42):e8234. doi: 10.1097/MD.0000000000008234.

Abstract

This study aimed to investigate the efficacy and safety of celecoxib 24 hours preoperative, 1 hour preoperative, and 4 hours postoperative administration in patients with arthroscopic knee surgery (AKS).In all, 206 patients who underwent AKS were consecutively recruited and randomized into 3 groups: (1) early preoperative analgesia group (EPEA), celecoxib 400 mg 24 hours preoperative administration; (2) preoperative analgesia group (PEA), celecoxib 400 mg 1 hour preoperative administration; (3) postoperative analgesia group (POA), celecoxib 400 mg 4 hours postoperative administration. Pain visual analog scale (VAS) scores (at rest and at 90 flexion) and patient global assessment (PGA) score were evaluated before and after operation, and also pethidine consumption and adverse events (AEs).The pain-rest VAS score, percentage of patients with moderate-severe pain at rest, and PGA score in the EPEA and PEA groups were decreased compared with POA group at 8 and 12 hours postoperation. Besides, pain-flexion to 90 VAS score in EPEA and PEA groups were also reduced compared with POA group at 8 hours postsurgery. Interestingly, the percentage of patients with moderate-severe pain at 90 flexion at 8 hours postsurgery in PEA group was fewer compared with POA group, whereas at 4 hours postoperation it was reduced in EPEA group compared with PEA and POA groups. As to consumption of pethidine, it was numerically decreased in EPEA and PEA groups compared with POA group. No difference between each 2 groups was found in AEs.Celecoxib was effective and safe as pre-emptive analgesia in AKS, and 1 hour administration before operation might be an optimal choice.

摘要

本研究旨在调查塞来昔布在膝关节镜手术(AKS)患者术前24小时、术前1小时及术后4小时给药的有效性和安全性。总共连续招募了206例行AKS的患者,并随机分为3组:(1)术前早期镇痛组(EPEA),术前24小时给予塞来昔布400毫克;(2)术前镇痛组(PEA),术前1小时给予塞来昔布400毫克;(3)术后镇痛组(POA),术后4小时给予塞来昔布400毫克。评估手术前后的疼痛视觉模拟量表(VAS)评分(静息时和屈曲90度时)、患者整体评估(PGA)评分,以及哌替啶用量和不良事件(AE)。术后8小时和12小时,EPEA组和PEA组的静息疼痛VAS评分、静息时中重度疼痛患者的百分比以及PGA评分均低于POA组。此外,术后8小时,EPEA组和PEA组的屈曲90度疼痛VAS评分也低于POA组。有趣的是,术后8小时,PEA组屈曲90度时中重度疼痛患者的百分比低于POA组,而术后4小时,EPEA组该百分比低于PEA组和POA组。至于哌替啶用量,EPEA组和PEA组在数值上低于POA组。各组之间在不良事件方面未发现差异。塞来昔布作为AKS的超前镇痛有效且安全,术前1小时给药可能是最佳选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a31/5662377/974101bea7a8/medi-96-e8234-g001.jpg

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