Ban Wen-Rui, Zhang Ery-Ang, Lv Lei-Feng, Dang Xiao-Qian, Zhang Chen
The First Department of Orthopedics, the Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an Shaanxi, 710004, P. R China.
Clinics (Sao Paulo). 2017 Dec;72(12):729-736. doi: 10.6061/clinics/2017(12)03.
This study examined periarticular multimodal drug injection and the use of nonsteroidal anti-inflammatory drugs for an early analgesic effect after total knee arthroplasty and total hip arthroplasty. Patient satisfaction and benefits from the treatment were also assessed.
A total of 110 patients who were scheduled to undergo total knee arthroplasty and 86 patients who were scheduled to undergo total hip arthroplasty were divided into two groups, the study group and the control group. The study group received a periarticular multimodal drug injection during surgery. The control group received an equal volume of normal saline. All patients received an analgesia pump and a moderate dose of nonsteroidal anti-inflammatory drugs. Resting and motion Numeric Rating Scale scores, the Western Ontario and McMaster Universities Arthritis Index, knee or hip joint range of motion, length of postoperative hospital stay, patient satisfaction, total nonsteroidal anti-inflammatory drug consumption and side effects were recorded.
Both study groups exhibited significant improvement in pain Numeric Rating Scale scores during rest and exercise several days after the surgery. The range of joint motion was greater in the study group, and the length of postoperative hospital stay was shorter than that in the control group. Patients in the study group consumed fewer nonsteroidal anti-inflammatory drugs and reported greater satisfaction with surgery.
Intraoperative periarticular multimodal drug injection significantly relieved pain after surgery and reduced nonsteroidal anti-inflammatory drug consumption. These patient had a better postoperative experience, including satisfaction and rehabilitation.
本研究探讨全膝关节置换术和全髋关节置换术后关节周围多模式药物注射及非甾体类抗炎药的早期镇痛效果。同时评估患者满意度及治疗的获益情况。
将110例计划行全膝关节置换术的患者和86例计划行全髋关节置换术的患者分为两组，即研究组和对照组。研究组在手术期间接受关节周围多模式药物注射。对照组接受等量生理盐水。所有患者均使用镇痛泵并给予中等剂量的非甾体类抗炎药。记录静息和活动时的数字评定量表评分、西安大略和麦克马斯特大学骨关节炎指数、膝关节或髋关节活动范围、术后住院时间、患者满意度、非甾体类抗炎药总消耗量及副作用。
两个研究组在术后数天的静息和运动时疼痛数字评定量表评分均有显著改善。研究组的关节活动范围更大，术后住院时间比对照组短。研究组患者的非甾体类抗炎药消耗量更少，对手术的满意度更高。
术中关节周围多模式药物注射可显著减轻术后疼痛并减少非甾体类抗炎药消耗量。这些患者术后体验更佳，包括满意度和康复情况。
