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肩关节镜检查后的恢复:住院治疗与门诊治疗

Recovery after shoulder arthroscopy: Inpatient versus outpatient management.

作者信息

Boissard M, Crenn V, Noailles T, Campard S, Lespagnol F

机构信息

CCOT, service d'orthopédie, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.

CCOT, service d'orthopédie, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.

出版信息

Orthop Traumatol Surg Res. 2018 Feb;104(1):39-43. doi: 10.1016/j.otsr.2017.10.010. Epub 2017 Dec 9.

Abstract

INTRODUCTION

Shoulder arthroscopy is particularly suited to outpatient surgery, thanks to advances in anesthetic and analgesic techniques. The main goal of this study was to compare postoperative recovery after shoulder arthroscopy between outpatient and inpatient management.

HYPOTHESIS

There is no difference in functional recovery between inpatient and outpatient management.

MATERIALS AND METHOD

A single-center, single-operator prospective study was conducted. Both groups received patient-controlled analgesia via an interscalene catheter. The inclusion criterion was shoulder arthroscopy for rotator cuff tendinopathy. The choice between inpatient and outpatient management was left to the patient. The study endpoint was postoperative recovery assessed on QOR-15 at days 1, 2, 3, 4 and 7 and on Quick-DASH at 6 weeks.

RESULTS

Forty-nine patients were included, divided into 2 groups. The outpatient (OP) and inpatient (IP) groups were comparable. Reconstructive surgery accounted for 54% of cases in OP versus 62% in IP. There was no significant difference in recovery in the first postoperative days (QOR-15) or at 6 weeks (Quick-DASH) (p>0.05). Pain on visual analog scale (VAS) was significantly greater in OP after discharge home.

DISCUSSION

No significant difference in postoperative recovery was observed between groups. Nevertheless, pain management and patient information for outpatients need improving.

LEVEL OF EVIDENCE

II, comparative study.

摘要

引言

由于麻醉和镇痛技术的进步,肩关节镜检查特别适合门诊手术。本研究的主要目的是比较门诊和住院管理下肩关节镜检查后的术后恢复情况。

假设

住院和门诊管理在功能恢复方面没有差异。

材料与方法

进行了一项单中心、单操作者的前瞻性研究。两组均通过肌间沟导管接受患者自控镇痛。纳入标准为因肩袖肌腱病行肩关节镜检查。住院和门诊管理的选择由患者决定。研究终点是在术后第1、2、3、4和7天通过QOR-15以及在6周时通过Quick-DASH评估的术后恢复情况。

结果

纳入49例患者,分为2组。门诊(OP)组和住院(IP)组具有可比性。重建手术在OP组的病例中占54%,在IP组中占62%。术后最初几天(QOR-15)或6周时(Quick-DASH)的恢复情况没有显著差异(p>0.05)。出院回家后,门诊患者的视觉模拟量表(VAS)疼痛评分明显更高。

讨论

两组之间在术后恢复方面未观察到显著差异。然而,门诊患者的疼痛管理和患者信息需要改善。

证据级别

II级,比较研究。

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