Teng Yuanjun, Jiang Jin, Chen Shaolong, Zhao Lianggong, Cui Zhaohui, Khan Md Shahidur, Du Wenjia, Gao Xuren, Wang Jing, Xia Yayi
Orthopaedics Key Laboratory of Gansu Province, The Second Hospital of Lanzhou University, Lanzhou University, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, 730030, Gansu Province, People's Republic of China,
Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1949-57. doi: 10.1007/s00167-013-2566-0. Epub 2013 Jun 20.
A systematic review and meta-analysis based on randomized controlled trials (RCTs) were conducted to evaluate the efficiency and safety of periarticular multimodal drug injection in total knee arthroplasty (TKA).
Periarticular injection with the use of multimodal drugs is an efficient alternative for postoperative analgesia in TKA. A systematical electronic search was performed to identify the eligible RCTs in the databases of PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science and the Chinese Biomedical Literature Database. Two independent reviewers completed data collection and assessment of methodological quality. The quality of evidence of outcomes was judged using GRADE criteria. Meta-analysis was performed for the outcomes of pain, straight leg raise, operating time, hospital stay and complications.
Ten RCTs including eight studies with 1,216 TKAs in 835 patients met the inclusion criteria. Periarticular injection with multimodal drugs in TKA was associated with short-term benefits in terms of pain relief, straight leg raise, narcotic consumption, and the rates of nausea, vomiting, rash and pruritus. There were no statistically significant differences in operating time, hospital stay, wound complications and deep vein thrombosis between both groups.
The current evidence suggests that periarticular multimodal drug injection in TKA provides short-term advantages in pain relief, straight leg raise and postoperative complications.
进行一项基于随机对照试验（RCT）的系统评价和荟萃分析，以评估全膝关节置换术（TKA）中关节周围多模式药物注射的有效性和安全性。
关节周围注射多模式药物是TKA术后镇痛的一种有效替代方法。进行了系统的电子检索，以在PubMed、Embase、Cochrane对照试验中央注册库、科学网和中国生物医学文献数据库中识别符合条件的RCT。两名独立的评审员完成了数据收集和方法学质量评估。使用GRADE标准判断结局的证据质量。对疼痛、直腿抬高、手术时间、住院时间和并发症等结局进行荟萃分析。
10项RCT（包括8项研究，共835例患者的1216例TKA）符合纳入标准。TKA中关节周围注射多模式药物在缓解疼痛、直腿抬高、减少麻醉药物用量以及恶心、呕吐、皮疹和瘙痒发生率方面具有短期益处。两组在手术时间、住院时间、伤口并发症和深静脉血栓形成方面无统计学显著差异。
目前的证据表明，TKA中关节周围多模式药物注射在缓解疼痛、直腿抬高和术后并发症方面具有短期优势。
