Screening Of The Compatibility Of Intravenous Self-controlled Analgesic Drugs After Knee Arthroplasty

Objective:By analyzing the effects of currently used PCIA drug formulations on analgesia,sedation,comfort and satisfaction of patients after knee replacement surgery(TKA),one or more PCIA formulas are optimized.Methods:144 patients with satisfactory analgesia(VAS score ?3)at 6 and 24 hours after selective TKA operation under lumbar anesthesia were collected from August 2018 to August 2019 at the Second Hospital of Shanxi Medical University.According to Ramsay Sedation score(6-point method)6 hours after operation,record patients with sedation satisfaction scores of 1,2,3 and 4 as Group 1,2,3 and 4.We adopted Likert-5satisfaction score and BCS comfort score in operation after 6h and 24 h to give the patients scores,and counted the adverse reactions,so as to evaluate the optimal group of PCIA effect,and counted the PCIA drug formula.Results:After 6 hours of operation,the comfort level of Group 1 was significantly lower than that of other groups,and the difference was statistically significant;after 24 hours of operation,the comfort level of Group 2 was the highest,followed by Group 3and Group 4,and Group 1 was the lowest,and the difference was statistically significant;after 6 hours and 24 hours of operation,the satisfaction level of Group 2was the highest,and the comfort level of Group 2,3,4 and 1 decreased successively,and the difference between each two groups was statistically significant.Theincidence of postoperative adverse reactions was highest in Group 1.In group 2 with the highest satisfaction and comfort level,there are the following four PCIA formulas:Formula A: Sufentanil(2.0 ug/kg)+Flurbiprofen Ester(3.0 mg/kg)+ Dexmedetomidine(4.5 ug/kg);Formula B: Sufentanil(2.0 ug/kg)+ Ketorolac Trometamol(3.0 mg/kg)+Dexmedetomidine(4.5 ug/kg);Formula C: Dezocine(0.6 mg/kg)+ dexmedetomidine(4.5 ug/kg);Formula D: Butorphino(0.18 mg/kg)+ dexmedetomidine(4.5 ug/kg).In terms of comfort and satisfaction at 6 hours after surgery,the scores of formula A and B groups were higher than other groups,and the difference was significant(P <0.05).In terms of comfort at 24 hours after surgery,group A was higher than other groups.,The difference was significant(P <0.05);and in terms of 24 h postoperative satisfaction,the satisfaction of formula C group was lower than the other three groups,and the difference was significant(P <0.05).Conclusion:For patients with PCIA after TKA,on the basis of satisfaction with analgesia,patients with Ramsay score of 2 had the highest PCIA comfort and satisfaction.Therefore,the preferred PCIA formula is: Sufentanil(2.0 ug/kg)+Flurbiprofen Ester(3.0 mg/kg)+ Dexmedetomidine(4.5 ug/kg),and Sufentanil(2.0 ug/kg)+Ketorolac Trometamol(3.0 mg/kg)+ Dexmedetomidine(4.5 ug/kg).