Xiao Xia, Zhang Qing, Ouyang Zhengxiao, Guo Xiaoning
Department of Orthopedics Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Medicine (Baltimore). 2018 Sep;97(37):e12391. doi: 10.1097/MD.0000000000012391.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. The purpose of this study was to evaluate the postoperative pain relief, time to ambulation, and opioid-sparing effects of flurbiprofen axetil (FA) and celecoxib (CX) after total-knee arthroplasty (TKA) surgery.A convenience sample of 300 patients was obtained using a retrospective chart review of patients who underwent TKA and received FA or CX or saline (SA) as control. Institutional review board approval was obtained, and 300 charts of patients who received TKA were reviewed. Visual analog scale (VAS) pain scores up to 6 months postoperatively, opioid requirements, range of knee motion, adverse effects, and length of hospital stay are recorded. Data were analyzed using the Pearson Chi-square where appropriate or the Fisher exact test, and all continuous variables were examined using a Wilcoxon rank test.The results of the study showed no significant differences between the 3 groups for the age, gender, American Society of Anesthesiologists class, number of patients who underwent knee surgery, weight, height, and operation duration. Patients in FA and CX demonstrated significantly reduced pain scores and less morphine consumption at rest and active motion compared to SA in 24 hours after surgery, with lower scores and less opioid requirements in the FA group. However, after 48 hours postoperatively, there are no significant differences between these groups.Intravenous application of 1 mg/kg flurbiprofen axetil twice a day and 200 mg celecoxib once a day improved analgesia and decreased morphine consumption following TKA. When the 2 active drugs were compared, it was found that flurbiprofen axetil was superior to celecoxib in terms of short-term analgesic efficacy and opioid consumption.
非甾体类抗炎药(NSAIDs)被推荐用于多模式术后疼痛管理。本研究的目的是评估氟比洛芬酯(FA)和塞来昔布(CX)在全膝关节置换术(TKA)后对术后疼痛缓解、下床活动时间和阿片类药物节省效应。通过对接受TKA并接受FA或CX或生理盐水(SA)作为对照的患者进行回顾性病历审查,获得了300例患者的便利样本。获得了机构审查委员会的批准,并审查了300例接受TKA患者的病历。记录术后长达6个月的视觉模拟量表(VAS)疼痛评分、阿片类药物需求量、膝关节活动范围、不良反应和住院时间。在适当情况下使用Pearson卡方检验或Fisher精确检验分析数据,所有连续变量使用Wilcoxon秩和检验进行检查。研究结果显示,三组在年龄、性别、美国麻醉医师协会分级、接受膝关节手术的患者数量、体重、身高和手术持续时间方面无显著差异。与术后24小时的SA组相比,FA组和CX组患者在休息和活动时的疼痛评分显著降低,吗啡消耗量减少,FA组的评分更低,阿片类药物需求量更少。然而,术后48小时后,这些组之间无显著差异。每天两次静脉注射1mg/kg氟比洛芬酯和每天一次口服200mg塞来昔布可改善TKA后的镇痛效果并减少吗啡消耗量。当比较这两种活性药物时,发现氟比洛芬酯在短期镇痛效果和阿片类药物消耗量方面优于塞来昔布。