Efficacy Analysis Of Pregabalin Combined With Celecoxib In Preemptive Analgesia For Total Knee Arthroplasty

Objective: Preemptive analgesia is an important part of multimodal analgesia.This topic aims to investigate the clinical efficacy of pregabalin combined with celecoxib in preemptive analgesia for total knee arthroplasty.Methods: Between May 2019 and May 2021,a total of 160 cases of total knee arthroplasty(TKA)who met the inclusion and exclusion criteria were included.According to the random number table method,they were divided into 4 groups:placebo group,celecoxib group,pregabalin group,and combination group.12 hours before and 4 hours before surgery,the placebo group was given the same amount of placebo,the celecoxib group was given celecoxib 200 mg,the pregabalin group was given pregabalin 150 mg,and the combination group was given pregabalin 150 mg and celecoxib 200 mg.The following indicators of the four groups were observed and recorded: dynamic and rest VAS scores within 48 hours after surgery,cumulative dose of sufentanil within 48 hours after surgery,knee flexion angle within 72 hours after surgery,and C reactive protein within 72 hours after surgery,time to first straight leg raise test success,and assessment of complications such as nausea,vomiting,and excessive sedation.Multivariate analysis was used to explore the independent risk factors of affecting the early postoperative recovery of knee joint function.SPSS 26.0software was used for statistical analysis.Reslut:11 patients withdrew during the study,and a total of 149 patients eventually entered the data analysis.The dynamic and rest VAS scores of the combination group,celecoxib group,and pregabalin group were significantly lower than those of the placebo group at 6,12,and 24 hours after surgery(P<0.05).The dynamic VAS scores at 6,12,24 and 48 hours after surgery were significantly lower than those in the other three groups(P<0.05).The dynamic VAS scores in the combined group showed a continuous downward trend with time.The cumulative dose of sufentanil in the combined group(49.30±10.91ug)within 48 hours after the operation was the lowest among the four groups(P<0.05),while the celecoxib group(62.38±12.97ug)and the pregabalin group(62.17±0.05)were significantly lower than the control group(74.18±15.29 ug,P<0.05).The C-reactive protein of the combined group was significantly lower than that of the other three groups at 6,12,24,and 48 hours after operation(P<0.05).The maximum knee flexion angle of the combined group at 24,48 and 72 hours after operation was significantly higher than that of the other three groups(P<0.05).The time required for the successful first straight leg raising test in the combined group was significantly shorter than that in the other three groups(P<0.05).The incidence of PONV in the combined group was significantly lower than that in the other three groups(P<0.05).There was no significant difference in postoperative nausea,excessive sedation,gastrointestinal bleeding and other complications among the four groups(P>0.05).Mean dynamic VAS score within 48 hours after operation,BMI index,and mean C-reactive protein within 72 hours after operation were independent risk factors for the maximum knee flexion angle at 72 hours after operation.Conclusion:1.Pregabalin combined with celecoxib has a good effect on acute pain control and reduction of opioid dosage after TKA,which is better than the single drug regimen without increasing postoperative complications incidence rate.2.Pregabalin combined with celecoxib preemptive analgesia can effectively control the level of inflammatory factors in the body after TKA.3.Pregabalin combined with celecoxib for preemptive analgesia can have a positive effect on early recovery of knee joint function by reducing the degree of pain and the level of inflammatory factors in the body after TKA.