Department of Orthopaedic Surgery, Uijeongbu St Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Gyeonggi-do, South Korea.
J Arthroplasty. 2012 Oct;27(9):1731-1736.e1. doi: 10.1016/j.arth.2012.03.054. Epub 2012 Jun 6.
We investigated the safety and efficacy of the bilateral periarticular multimodal drug injection (PMDI) at a reduced dosage in patients undergoing simultaneous bilateral total knee arthroplasty (SBTKA). In total, 45 patients undergoing SBTKA received 65 mL PMDI in each knee (reduced-dose group). The incidence of drug-related adverse effects and wound complications were evaluated. Pain levels during the night of the operation and postoperative day 1 and opioid consumption during the first 24 hours after surgery were compared with the regular-dose group of 55 patients undergoing SBTKA who received 100 mL of PMDI in 1 knee. No patient experienced a serious drug-related adverse effect or wound complication. Blood levels of ropivacaine were observed to be lower than a toxic level throughout the monitored period in all patients examined. Patients in the reduced-dose group experienced less pain during the night of operation, but a similar pain level at postoperative day 1.
我们研究了在双侧全膝关节置换术（SBTKA）中减少剂量的双侧关节周围多模式药物注射（PMDI）的安全性和有效性。共有 45 例接受 SBTKA 的患者在每侧膝关节中接受 65 毫升 PMDI（低剂量组）。评估了药物相关不良反应和伤口并发症的发生率。比较了手术当晚和术后第 1 天的疼痛水平以及术后 24 小时内的阿片类药物消耗，与 55 例接受 SBTKA 的常规剂量组患者进行比较，该组患者在 1 侧膝关节中接受 100 毫升 PMDI。没有患者出现严重的药物相关不良反应或伤口并发症。在所有接受检查的患者中，观察到罗哌卡因的血药浓度在整个监测期间均低于中毒水平。低剂量组患者在手术当晚的疼痛程度较轻，但术后第 1 天的疼痛程度相似。
