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全髋关节置换术后关节周围药物浸润对术后疼痛的疗效:一项系统评价和荟萃分析。

The efficacy of periarticular drug infiltration for postoperative pain after total hip arthroplasty: A systematic review and meta-analysis.

作者信息

Wang Yanyang, Gao Fuqiang, Sun Wei, Wang Bailiang, Guo Wanshou, Li Zirong

机构信息

The Graduate School of Peking Union Medical College Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.

出版信息

Medicine (Baltimore). 2017 Mar;96(12):e6401. doi: 10.1097/MD.0000000000006401.

Abstract

BACKGROUND

The ability of intraoperative periarticular drug infiltration (PDI) to control pain after total hip arthroplasty (THA) has been studied for many times, but it still remains controversial. Therefore, we undertook a meta-analysis to evaluate the efficacy and safety of PDI on postoperative pain after THA.

METHODS

Databases, including Pubmed, Medline, Embase, Web of Science, and Cochrane library, were searched to identify randomized controlled trials concerning PDI for pain management in patients undergoing THA. The primary outcomes included pain score with rest or activity and opioid consumption. Secondary outcomes were length of hospital stay and complications (nausea or vomiting).

RESULTS

A total of 666 THA patients from 8 randomized controlled trials were subjected to meta-analysis. The results showed that the PDI group had better pain relief, less opioid consumption, and less length of hospital, when compared with the placebo group (P < 0.05). No significant differences were observed in regard to visual analog score with activity and complications between the 2 groups.

CONCLUSION

PDI may be recommended for the pain management after THA. However, due to the variations in the included studies, additional studies are still needed to validate these conclusions.

摘要

背景

术中关节周围药物浸润(PDI)对全髋关节置换术(THA)后疼痛的控制能力已被多次研究,但仍存在争议。因此,我们进行了一项荟萃分析,以评估PDI对THA术后疼痛的疗效和安全性。

方法

检索包括Pubmed、Medline、Embase、科学网和考克兰图书馆在内的数据库,以确定关于PDI用于THA患者疼痛管理的随机对照试验。主要结局包括静息或活动时的疼痛评分以及阿片类药物消耗量。次要结局为住院时间和并发症(恶心或呕吐)。

结果

对来自8项随机对照试验的666例THA患者进行了荟萃分析。结果显示,与安慰剂组相比,PDI组疼痛缓解更好、阿片类药物消耗量更少且住院时间更短(P<0.05)。两组在活动时的视觉模拟评分和并发症方面未观察到显著差异。

结论

PDI可推荐用于THA后的疼痛管理。然而,由于纳入研究存在差异,仍需要更多研究来验证这些结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/5371473/0bfc06a38522/medi-96-e6401-g001.jpg

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