| BackgroundKnee joint disease is the main cause of lower limb pain and disability in the elderly,and knee replacement surgery can cure it.However,effective control of postoperative pain,relief of stress response,and early functional exercise are keys of successful operation.Hydrochloride oxycodone injection is an opioid receptor agonist with rapid onset,strong analgesic effect,and little side effect.Flurbiprofen is a non-steroidal anti-inflammatory drug,with antipyretic,anti-inflammatory and analgesic effects.Oxycodone and flurbiprofen are commonly used as analgesics after knee surgery.In order to find a drug with better analgesic effect and lower adverse reaction and being more conducive to the recovery of postoperative analgesia in elderly patients with knee joint surgery,this study chosed opioid oxycodone and non-steroidal drugs flurbiprofen used in elderly patients after total knee arthroplasty,to compare and observe the analgesic effect,inflammation,stress response,adverse reaction between the both drugs ObjectiveTo evaluate efficacy,adverse reaction and effect of hydrochloride oxycodone injection and flurbiprofen on postoperative analgesia in elderly patients undergoing total knee arthroplasty,and to compare and analyze the clinical effect between the both drugs.Methods116 cases of elderly patients who received unilateral total knee arthroplasty(TKA)under general anesthesia were randomly divided into 2 groups,and were respectively given equivalent dose of hydrochloride oxycodone and flurbiprofen axetil injection withintravenous analgesia pump after operation.The parameters of the self-controlled analgesia pump were designed as follows: the maintenance dose was 2 ml/h,the PCA was 0.5 ml/times,the locking time was 15 min.Formula: Group A: 50 mg hydrochloride oxycodone injection +0.9% normal saline to 100 ml;Group B: 150 mg flurbiprofen axetil Injection+0.9% normal saline to 100 ml.the resting visual analogue scale(VAS)score,dynamic VAS score and sedation score were monitored and evaluated at 6 h,12 h,24 h and 48 h after surgery.Measure the C reactive protein(CRP),T lymphocyte subsets,IL-6,IL-10,TNF-? levels in serum at general anesthesia extubation,6 h,12 h,24 h,48 h after surgery;Record the tramadol determine the knee joint activity at 24 h and 48 h after surgery.Compare the incidence of adverse reactions during hospitalization and evaluate the knee joint function before discharged..Results1 The VAS score and dynamic VAS score in Group A were significantly lower than those in the Group B after operation,and the difference was statistically significant(P<0.05).2 The differences of IL-6,IL-10 and TNF-? were not statistically significant between patients of two groups at each time point after operation(P>0.05).3 The differences of CRP,CD4+,CD8+ levels and CD4+/CD8+ ratio were not statistically significant between patients of two groups at each time point after operation(P>0.05).4 The knee joint activity at 24 h after surgery were not comparable between the two groups(P>0.05),but the knee joint activity in group A at 48 h after surgery were obviously higher than that in group B,and the difference was statistically significant(P<0.05).5 The HSS score before surgery were not comparable between the two groups(P>0.05),but the HSS score in group A after surgery were obviously higher than that in group B,and the difference was statistically significant(P<0.05).6 The total adverse reaction rate was 8.62% in Group A;the incidence of adversereaction was 10.34% in Group B,and the total incidences of adverse reaction between two groups were not comparable(?2=0.100,P=0.751).ConclusionsIn elderly patients after total knee arthroplastyIntravenous controlled analgesia oxycodone hydrochloride injection analgesia and sedative effect is superior to flurbiprofen axetil injection,Intravenous controlled analgesic administration of oxycodone hydrochloride was superior to flurbiprofen axetil in patients with postoperative knee function recovery. |
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