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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (2): 293-298. doi: 10.19723/j.issn.1671-167X.2024.02.014

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Comparison of the early analgesic efficacy of three different drugs after anterior cruciate ligament reconstruction

Jiangjing WANG1,2,Shunyi WEI3,Yingfang AO3,Yuping YANG3,*()   

  1. 1. Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province, Cangzhou 061001, Hebei, China
    2. Hebei Key Laboratory of Integrated Traditional and Western Medicine in Osteoarthrosis Research (Pre-paring), Cangzhou 061001, Hebei, China
    3. Department of Sports Medicine, Peking University Third Hospital, Beijing 100191, China
  • Received:2022-10-17 Online:2024-04-18 Published:2024-04-10
  • Contact: Yuping YANG E-mail:yyyyppvip@sina.com
  • Supported by:
    Key Special Project for Science and Technology Winter Olympics of Ministry of Science and Technology of China(2019YFF0302305);the Zhangjiakou Science and Technology Winter Olympics Technology Integration Application and Comprehensive Demonstration Special Topic(20110004D)

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Abstract:

Objective: The pain-relieving effect and safety of compound aminopyrine phenacetin tablets, tramcontin (tramadol hydrochloride sustained-release tablets) and dolantin in the early stage of autologous tendon reconstruction of the anterior cruciate ligament (ACL) of the knee joint were compared. Methods: Retrospective analysis of postoperative pain and drug analgesia in 45 patients performed by the same group from November 2018 to February 2019. The random area group design was divided into two groups according to whether ACL rupture was combined with meniscal injury, group A was 24 patients with ACL reconstruction of knee joint and group B was 21 patients with ACL fracture combined with meniscus injury. The two groups were divided into three subgroups respectively according to the actual treatment of postoperative analgesic drugs received by the patients, including 4 cases of compound aminopyrine phenacetin tablets, 11 cases of oral tramcontin, 9 cases of intramuscular dolantin combined with phenergan in group A; 3 cases of compound aminopyrine phenacetin tablets, 10 cases of oral tramcontin, and 8 cases of intramuscular dolantin combined with phenergan in group B. When the early postoperative patients complain about pain and actively ask for analgesia. When the patients complained about pain after the operation and actively asked for analgesia, they were randomly given painkillers, tramcontin or dolantin combined with phenergan to relieve pain. Pain visual analogue scale (VAS) was used to evaluate pain relief and observe the occurrence of adverse reactions. Results: There were no significant dif-ferences in gender, age, body mass index, and time of hospital stay between the two groups of patients (P > 0.05). In the patients who used tramcontin and dolantin combined with phenergan to relieve pain judging by VAS score before and 1 h after taking the drug, it was found that the pain situation of the patient was significantly relieved, and the difference before and after taking the drug had statistical significance (P < 0.05). Pairwise comparisons of the three drugs applied in the two groups showed significantly greater pain relief in the dolantin combined with phenergan group than in the remaining two drugs. There was no significant difference (P > 0.05). Dolantin was prone to nausea and vomiting, but the application of phenergan was also used to reduce side effects. In terms of adverse reactions, only 1 case of nausea occurred in the tramcontin group for simple ACL reconstruction, and none of the patients in the other groups showed serious complications and allergic reactions. Conclusion: Whether in cruciate ligament reconstruction alone or combined with meniscus molding or suture, compound aminopyrine phenacetin tablets, tramcontin, dolantin combined with phenergan can effectively relieve pain. Among the three drugs, dolantin caused the largest pain relief. At the same time, the combination of phenergan effectively reduced the adverse reactions, such as vomiting and nausea, and increased the drug safety.

Key words: Anterior cruciate ligament reconstruction, Meniscus injuries, Analgesia, Analgesics, opioid

CLC Number: 

  • R687.4

Table 1

Comparison of general data between the two groups"

Items Group A Group B t/χ2 P
Age/years, $\bar x \pm s$ 35.85±4.25 34.25±6.26 0.035 0.972
Male/Female, n 15/9 17/4 0.067 0.759
BMI, $\bar x \pm s$ 21.76±3.25 22.17±3.42 0.043 0.966
Length of hospitalisation/d, $\bar x \pm s$ 3.75±0.62 3.52±0.46 0.266 0.791

Figure 1

Arthroscopically reconstructed anterior cruciate ligament"

Figure 2

Arthroscopically stitched medial meniscus"

Table 2

Comparison of preoperative and postoperative VAS scores for three different analgesic drugs in group A"

Group n Before taking the medicine, $\bar x \pm s$ After taking the medicine, $\bar x \pm s$ t P
Compound aminopyrine phenacetin tablets 4 5.000±0.000 2.500±0.577 8.660 0.003
Tramcontin 11 5.000±0.447 2.455±0.522 12.279 ＜0.001
Dolantin combined with phenergan 9 6.444±0.527ab 2.111±0.333 18.385 ＜0.001
F 29.186 1.631
P ＜0.001 0.220

Table 3

Comparison of preoperative and postoperative VAS scores for three different analgesic drugs in group B"

Group n Before taking the medicine, $\bar x \pm s$ After taking the medicine, $\bar x \pm s$ t P
Compound aminopyrine phenacetin tablets 3 5.667±0.577 2.333±0.577 5.000 0.038
Tramcontin 10 5.600±0.843 2.500±0.527 11.196 ＜0.001
Dolantin combined with phenergan 8 6.750±0.463ab 2.375±0.518 23.910 ＜0.001
F 6.709 0.181
P 0.007 0.836

Table 4

Comparison of the difference of VAS score before and after three different analgesic drugs between group A and B"

Group Before taking the medicine, $\bar x \pm s$ Compound aminopyrine phenacetin tablets, $\bar x \pm s$ Tramcontin, $\bar x \pm s$ Dolantin combined with phenergan, $\bar x \pm s$ F P
Group A 5.59±0.85 2.75±0.96 2.60±0.70 4.33±0.71ab 6.217 0.008
Group B 6.95±0.86 3.75±1.26 3.00±0.89 4.43±0.53cd 4.572 0.025
t 3.379 -1.265 -1.133 -0.307
P 0.045 0.253 0.271 0.875
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