Canata Gian Luigi, Casale Valentina, Chiey Alfredo
Centre of Sports Traumatology, Koelliker Hospital, Turin, Italy.
Joints. 2017 Feb 7;4(4):222-227. doi: 10.11138/jts/2016.4.4.222. eCollection 2016 Oct-Dec.
this study was conducted to identify the most effective method of postoperative pain management, comparing the intravenous opiate infusion protocol with the use of a single periarticular local anesthetic infiltration (LAI) in patients undergoing total knee arthroplasty (TKA) surgery.
50 patients submitted to TKA surgery between 2013 and 2015 were divided into two groups. Buprenorphine was administered intravenously to the patients in Group A, while the Group B patients received a single periarticular LAI (ropivacaine and ketorolac) during surgery. Pain was assessed using a visual analog scale (VAS) and the knee injury and osteoarthritis outcome score. Hemoglobin and hematocrit were measured in the early postoperative period and at 40 days post-surgery. Range of motion and inflammatory markers were also assessed. Statistical analysis was performed using Student's t-test.
student's t-test showed no significant difference between the groups in functional outcomes or blood values, but a difference in VAS score on the day of surgery was found (p < 0.0001), in favor of Group B.
LAI considerably reduces postoperative pain, allowing rapid mobilization and accelerating functional recovery.
Level I, prospective single-blind randomized trial.
本研究旨在确定全膝关节置换术（TKA）患者术后疼痛管理的最有效方法，比较静脉注射阿片类药物输注方案与单次关节周围局部麻醉浸润（LAI）的效果。
将2013年至2015年间接受TKA手术的50例患者分为两组。A组患者静脉注射丁丙诺啡，而B组患者在手术期间接受单次关节周围LAI（罗哌卡因和酮咯酸）。使用视觉模拟量表（VAS）和膝关节损伤与骨关节炎疗效评分评估疼痛。在术后早期和术后40天测量血红蛋白和血细胞比容。还评估了活动范围和炎症标志物。使用学生t检验进行统计分析。
学生t检验显示两组在功能结局或血液值方面无显著差异，但在手术当天的VAS评分上存在差异（p < 0.0001），有利于B组。
LAI可显著减轻术后疼痛，使患者能够快速活动并加速功能恢复。
I级，前瞻性单盲随机试验。
