Titman Saskia, Hommel Ami, Dobrydnjov Igor, Johansson Anders
Department of Clinical sciences, Hässleholm Hospital, Skanevard KRYH, Sweden.
Department of Clinical Sciences, Lund University and Skane University Hospital, Lund, Sweden.
Int J Orthop Trauma Nurs. 2018 Feb;28:16-21. doi: 10.1016/j.ijotn.2017.10.003. Epub 2017 Oct 31.
Research regarding patients undergoing total hip arthroplasty (THA) has shown no significant difference in postoperative pain with or without the use of local infiltration analgesia (LIA). The aim was to evaluate whether intra-operative LIA with Ropivacaine in patients undergoing THA under general anaesthesia reduces postoperative pain.
A randomised, placebo-controlled trial. Forty patients undergoing elective primary THA under general anaesthesia were allocated to an intervention group (RG) who received 150 ml of LIA or a placebo group (CG) who received 150 ml of saline solution.
There were no differences in demographic data or duration of anesthesia. The total mean dose of morphine given was 16 ± 12 mg (RG) and 13 ± 9 mg (CG) (p=0.238). Pain scores (Numeric rating scale, NRS) on arrival at the PACU (time 0) were Md 1 in the RG groupvs Md 5 in the CG group (p = 0.026). During the first 2 h the Md NRS values in the RG group were ≤3 whereas the Md values in the CG were ≥3. No significant differences in NRS were found at 1-6 h after arrival at the PACU.
Our study suggests that there is a positive effect of LIA on pain scores within the first hour postoperatively in patients undergoing elective primary THA under general anaesthesia.
有关接受全髋关节置换术（THA）患者的研究表明，使用或不使用局部浸润镇痛（LIA），术后疼痛无显著差异。目的是评估在全身麻醉下接受THA的患者术中使用罗哌卡因进行LIA是否能减轻术后疼痛。
一项随机、安慰剂对照试验。40例在全身麻醉下接受择期初次THA的患者被分配至干预组（RG），接受150ml LIA，或安慰剂组（CG），接受150ml盐溶液。
人口统计学数据或麻醉持续时间无差异。给予的吗啡总平均剂量在RG组为16±12mg，在CG组为13±9mg（p=0.238）。到达麻醉后恢复室（PACU）时（时间0）的疼痛评分（数字评分量表，NRS），RG组中位数为1，而CG组为5（p=0.026）。在最初2小时内，RG组的NRS中位数≤3，而CG组的中位数≥3。到达PACU后1-6小时，NRS无显著差异。
我们的研究表明，在全身麻醉下接受择期初次THA的患者中，LIA对术后第一小时内的疼痛评分有积极影响。
