连续关节内及关节周围注射左旋布比卡因用于全膝关节置换术后疼痛缓解的管理：一项前瞻性随机双盲试验研究。
Continuous intraarticular and periarticular levobupivacaine for management of pain relief after total knee arthroplasty: A prospective randomized, double-blind pilot study.
作者信息
Di Francesco A, Flamini S, Pizzoferrato R, Fusco P, Paglia A
机构信息
Department of Orthopaedic Surgery, San Salvatore Hospital, via Vetoio, N° 1, 67100 L'Aquila, Italy.
Department of Anesthesiology, San Salvatore Hospital, via Vetoio, N° 1, 67100 L'Aquila, Italy.
出版信息
J Orthop. 2016 Mar 25;13(3):119-22. doi: 10.1016/j.jor.2016.02.003. eCollection 2016 Sep.
BACKGROUND
Total knee arthroplasty (TKA) can result in major postoperative pain which can impact the recovery and rehabilitation of patients and for this reason the use of a pain-control infusion pumps (PCIP) enhances analgesia for TKA.
PURPOSE
To investigate whether a PCIP of levobupivacaine would reduce pain in patients following TKA.
METHODS
This was a prospective, randomized, controlled study conducted in 55 patients. Criteria for participation were unilateral TKA for osteoarthritis and no allergies to levobupivacaine. The primary outcomes measured were postoperative pain intensity on Visual Analogue Scale (VAS) score measured at 24 h and 48 h. Other measures included amount of narcotics, presence of adverse events, and length of hospital stay.
RESULTS
PCIP-treated patients (n = 28) showed significant reductions in VAS score at any time versus control (p < 0.01). Amount of narcotics, presence of adverse events, and length of hospital stay were significantly less with the PCIP versus control (each p < 0.01).
CONCLUSION
The use of a mix of levobupivacaina, ketoral-trometamina, and adrenalin provides a safe and effective means in post-operative pain relief in patients undergoing TKA.
LEVEL OF EVIDENCE
Level II therapeutic study.
背景
全膝关节置换术（TKA）可导致严重的术后疼痛，这会影响患者的恢复和康复，因此使用疼痛控制输液泵（PCIP）可增强TKA患者的镇痛效果。
目的
研究左旋布比卡因PCIP是否能减轻TKA患者的疼痛。
方法
这是一项对55例患者进行的前瞻性、随机、对照研究。参与标准为因骨关节炎行单侧TKA且对左旋布比卡因无过敏反应。主要观察指标为术后24小时和48小时采用视觉模拟评分法（VAS）测量的疼痛强度。其他指标包括麻醉剂用量、不良事件的发生情况以及住院时间。
结果
与对照组相比，接受PCIP治疗的患者（n = 28）在任何时间的VAS评分均显著降低（p < 0.01）。与对照组相比，PCIP组的麻醉剂用量、不良事件的发生情况以及住院时间均显著减少（各p < 0.01）。
结论
使用左旋布比卡因、酮咯酸氨丁三醇和肾上腺素的混合制剂为接受TKA的患者提供了一种安全有效的术后疼痛缓解方法。
证据水平
II级治疗性研究。
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