中文摘要：

目的：探讨超前镇痛对全膝关节置换术（TKA）患者围术期疼痛及康复的影响。方法：105例单侧TKA患者随机分为A组（36例）、B组（32例）、C组（37例）。B组术前给予塞来昔布治疗，C组术前给予丁丙诺啡透皮贴剂治疗，A组为空白对照组。观察术后疼痛程度、膝关节主动屈曲最大角度及并发症；结果：与A组相比，B、C组患者术后疼痛控制较好、屈膝功能锻炼较早、膝关节屈曲最大角度较大（P〈0．05）。C组患者第5天静息痛明显低于A、B组（P〈0．05）。所有患者均未发生严重并发症。结论：膝关节置换术患者术前给予超前镇痛有助于围术期疼痛控制及早期功能锻炼。丁丙诺啡透皮贴剂是一种方便、可靠的超前镇痛药。

英文摘要：

Objective： To investigate the effect of preemptive analgesia on perioperative pain and postoperative functional recovery in patients receiving total knee arthroplasty （TKA）. Methods：A total of 105 unilateral TKA patients were randomly divided into three groups： group A （n=36）,B （n = 32） and C （n=37）.The patients were preoperatively treated with eelecoxib in group B, and with buprenorphine in group C.The group A was blank control group. The postoperative pain status, Active flexion range--of--motion of knee joint and complication were observed. Results： Compared with group A, there were better postoperative pain control effect,earlier functional exercise of knee joint and larger flexion range--of--motion in group B and C （P〈0.05）.The rest pain score at 5th day after surgery in group C was lower than that in group A and B （P〈0.05）.No severe complication was found in all patients.Conclusion： The preemptive analgesia was helpful for perioperative pain control and early functional excise in TKA patients,and the buprenorphine transdermal patch is feasible and effective for preemptive analgesia.