全膝关节置换术中使用类固醇进行局部浸润麻醉：随机对照试验的系统评价
Local infiltration anesthesia with steroids in total knee arthroplasty: A systematic review of randomized control trials.
作者信息
Tran Jonathan, Schwarzkopf Ran
机构信息
Department of Orthopaedic Surgery, Joint Replacement Service, University of California, Irvine, School of Medicine, Orange, CA 92868, USA.
出版信息
J Orthop. 2015 Feb 18;12(Suppl 1):S44-50. doi: 10.1016/j.jor.2015.01.017. eCollection 2015 Oct.
Abstract
Local infiltration anesthesia (LIA) with anesthetics, steroids, NSAIDS, and epinephrine has been shown to be effective in reducing total knee arthroplasty (TKA) postoperative pain. This systematic review explores the functional outcomes of randomized control trials that have compared the use of LIA with and without steroids during TKA. Five studies with 412 patients met the inclusion criteria, 228 received local infiltration anesthesia with steroids (LIAS) and 184 received local infiltration anesthesia without steroids (LIAWS). The use of LIAS in management of postoperative TKA pain has been shown to decrease the length of hospital stay, time required to achieve straight leg raise, and pro-inflammatory signals in patients. Although there is no overwhelming data to suggest LIAS improves postoperative TKA pain, current literature does support its effectiveness in producing other favorable surgical outcomes.
摘要
已证明使用麻醉剂、类固醇、非甾体抗炎药和肾上腺素进行局部浸润麻醉（LIA）可有效减轻全膝关节置换术（TKA）术后疼痛。本系统评价探讨了比较TKA期间使用含类固醇和不含类固醇的LIA的随机对照试验的功能结果。五项涉及412例患者的研究符合纳入标准，228例接受含类固醇的局部浸润麻醉（LIAS），184例接受不含类固醇的局部浸润麻醉（LIAWS）。已证明LIAS用于TKA术后疼痛管理可缩短患者住院时间、实现直腿抬高所需时间并降低促炎信号。尽管没有压倒性数据表明LIAS可改善TKA术后疼痛，但当前文献确实支持其在产生其他有利手术结果方面的有效性。
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