Application of multimodal analgesia in early stage of elderly patients with artificial knee arthroplasty
ZU Shufang1 XU Xiaodong1 TIAN Rui2
1.Department of Anesthesiology, Hefei Third Clinical College, Anhui Medical University (the Third People’s Hospital of Hefei), Anhui Province, Hefei 230031, China;
2.Clinical Medical College of Anhui Medical University, Anhui Province, Hefei 230031, China
Abstract：Objective To explore the application effect of multimodal analgesia in early stage of elderly patients with artificial knee arthroplasty. Methods From January 2016 to April 2020, 80 elderly patients who underwent artificial knee arthroplasty in Hefei Third Clinical College, Anhui Medical University (the Third People’s Hospital of Hefei) were selected, and they were divided into routine group (40 cases, who were given patient-controlled intravenous analgesia [PCIA]) and study group (40 cases, who were given multimodal analgesia, that was PCIA + ultrasound-guided nerve block + physical analgesia). Postoperative dose of Celecoxib Capsules was compared between two groups. The resting pain scores (visual analogue scale [VAS]) were compared between two groups at 12, 24, 48, and 72 h after surgery. The changes levels of serum neurotransmitters and stress response were compared between two groups immediately after surgery, 24 h after surgery, and 72 h after surgery. Results The dose of Celecoxib Capsules in study group was lower than that in routine group, and the difference was statistically significant (P < 0.05). VAS scores were compared between two groups at each time point, and the differences were statistically significant (P < 0.05); and VAS score of study group was lower than that of routine group at each time point, and the differences were statistically significant (P < 0.05). There were significant differences in the levels of substance P, β-endorphin (β-EP), 5-hydroxytryptamine (5-HT), cortisol (Cor), C-reactive protein (CRP), and white blood cell count (WBC) at each time point between two groups (P < 0.05); and the levels of substance P, β-EP, 5-HT, Cor, CRP, and WBC in study group at 24 and 72 h after surgery were lower than those in routine group, and the differences were statistically significant (P < 0.05). Conclusion The application of multimodal analgesia in early stage of elderly patients with artificial knee arthroplasty can reduce severe pain attack, relieve postoperative pain, control neurotransmitter levels and stress response.
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