| Objective:To explore the effect of multi-mode analgesia with traditional Chinese and western medicine on postoperative analgesia after TKA and the recovery of postoperative functional rehabilitation,and to study its safety.Methods:From April 2017 to December 2017,40 patients with severe knee osteoarthritis of unilateral TKA at Puyang City Hospital of Traditional Chinese Medicine in were enrolled in this study.The patients were randomly divided into study group and control group with 20 patients in each group.All the operations were performed by the same senior physician.All patients underwent painful teaching at the time of admission,so that patients could fully understand and cooperate with clinical treatment.Study group patients with integrated traditional Chinese and Western medicine multimodal analgesia program:4 days before the start of oral administration of JINGUTONGNING capsules,5 capsules/time,3 times/day,to 12 days after surgery,preoperative 6h oral celecoxib capsules,0.2g/time,1 time/day,to 12 days after operation,and more in the subcutaneous tissue before the operation,the infrapatellar fat pad,subperiosteum,patellar synovial membrane,patellar tendon and quadriceps tendon Point injection of"cocktail" analgesic mixture(Ropivacaine hydrochloride 200mg,dexamethasone 5mg,diluted to 100ml with saline),analgesic pump at the end of surgery will be connected to the epidural catheter,analgesia Pump drugs from morphine 5mg,0.75%bupivacaine 10 ml diluted with saline to 100ml composition.Patients in the control group did not take JINGUTONGNING capsule,the rest of the analgesic method with the study group.Two groups of patients if the application of the above pain relief method is still unbearable pain depending on the circumstances and then intramuscular injection of pethidine hydrochloride 50mg.After observing the VAS scores of rest and exercise pain,active and passive knee joint activities and KSS score of knee joint at various time points after the observation,we objectively evaluated and analyzed the effect of multi-mode analgesia combined with traditional Chinese and western medicine on TKA Analgesic effect of pain and recovery of joint function,and objectively evaluated the multi-mode analgesic program of traditional Chinese medicine and western medicine by observing whether the patient suffered from anorexia,dizziness,fatigue,fever,nausea and vomiting,drowsiness and rash during treatment TKA perioperative safety.Results:The VAS scores of rest pain in study group were better than those of control group(P<0.01).There was no significant difference between the two groups in VAS score of exercise pain at each time point(P>0.05).The active and passive knee activities of the study group were better than those of the control group(P<0.05).Clinical scores and functional scores of KSS scores of the study group were better than those before treatment(P<0.05).The scores of clinical scores and functional scores of KSS in the control group were better than those before treatment(P<0.05).The KSS scores of the two groups at 2 months after surgery were significantly lower than those before treatment There were no significant differences in clinical scores and functional scores between the two groups in the KSS score(P>0.05).No significant adverse reactions occurred in both groups during the course of treatment.Conclusion:Multi-modality analgesia with TCM combined with western medicine can relieve rest pain after TKA and improve the degree of postoperative active and passive joint movement.It can help the patients to perform functional exercise as soon as possible after surgery,but the pain after TKA and postoperative 2 months The KSS score has no significant effect.The multi-modality analgesia of traditional Chinese and western medicine was safe and no obvious adverse reactions were found.It provided a new idea for the treatment of TKA patients and had a high clinical value. |
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