Clinical Investigation of the Celecoxib’s Multimodal Effects on the Postoperative Analgesia of Orthopaedic Surgery
|School||Central South University|
|Keywords||Multimodal analgesia Celecoxib Celebrex Orthopedic surgery Postoperative analgesia|
Objective: To compare the study of bone and joint surgery after the application of the analgesic effects of celecoxib combined with PCA multi-modal analgesia and traditional postoperative analgesia method. Methods: 60 patients undergoing elective bone and joint surgery patients, 33 males and 27 females, aged 18-80 years, mean 44.3 years, were randomly divided into 2 groups: observation group (multi-modal analgesia group) postoperative Ⅳ PCA (the main component of fentanyl 0.02mg / h) 100 ml of postoperative day to five days after daily oral celecoxib 400mg changed to 200mg / d for 8 consecutive days, six days; control group (PCA group) surgery After using only Ⅳ PCA100ml. Every 4 hours were observed in patients with VAS pain scores, PCA pressing times in order to calculate the dosage of fentanyl, two days after vital signs (HR, RR, BP, SpO 2 ), side effects ( nausea, vomiting, pruritus, urinary retention), sleep disturbance, record the amount of bleeding, preoperative and postoperative 1,3 days blood check blood clotting full set of discharge patient satisfaction after discharge by telephone in January Patients were followed up to determine the incidence of chronic pain. Results: Postoperative control group (PCA group) analgesic effect of postoperative VAS score was significantly greater than the observation group (multi-modal analgesia group), there is a significant difference (p <0.05); multi-modal analgesia group after 8 - 12h ,12-16h ,16-20h time period dosage of fentanyl and postoperative 12h, 24h, 36h fentanyl use the total amount was significantly less than the PCA group, there is a significant difference (p <0.05); multi-modal analgesia group and the PCA group on the incidence of opioid adverse events was no significant difference (p> 0.05); sleep scores were significantly better than the PCA group of multi-modal analgesic group of patients, there is a significant difference (p <0.05); two groups between preoperative and postoperative blood parameters and blood loss no significant difference (p> 0.05); There were no significant differences in the two groups of patients in the postoperative period, heart rate, blood pressure, respiration, blood oxygen saturation ( p> 0.05); multimodal analgesia group satisfaction score and was discharged in January after the incidence of chronic pain significantly better than the PCA group, a significant difference (p <0.05). Conclusion: bone and joint surgery plug celecoxib combined PCA multi-modal analgesia was significantly superior to postoperative pure PCA analgesia: to improve postoperative analgesia, significantly reducing the amount of postoperative opioids, and improve the patient's sleep disorder to improve patient satisfaction in patients and to reduce discharged chronic pain incidence, almost does not affect the patient's platelets and coagulation.