Hutchinson Hank L, Jaekel David J, Lovald Scott T, Watson Heather N, Ong Kevin L
Tallahassee Orthopedic Clinic, Tallahassee, Florida.
Exponent, Inc., Menlo Park, California; e-mail:
J Surg Orthop Adv. 2019 Spring;28(1):58-62.
The purpose of this study was to evaluate a multimodal pain management program incorporating periarticular injections of liposomal bupivacaine after hemiarthroplasty treatment of femoral neck fractures. This retrospective study selected patients treated with periarticular injections of liposomal bupivacaine within the multimodal pain management program (LBUP) ( = 100) and a control group of patients treated without local infiltration ( = 78). Similar pain control was achieved between both groups from day 1 to day 4 postsurgery (min = .392). Length of stay was significantly lower for LBUP patients (4.8 days vs. 5.7 days, = .013), and LBUP patients were significantly more likely to be ambulatory at discharge (82% vs. 69%, = .013). LBUP patients were also less likely to need the intensive care unit (4% vs. 14%, = .027). The percentage of patients with at least one opioid-related adverse event was lower in the LBUP group (3% vs. 8%, = .156) as was the 90-day mortality rate (2% vs. 8%, = .069), but the differences were not statistically significant. (Journal of Surgical Orthopaedic Advances 28(1):58-62, 2019).
本研究的目的是评估一种多模式疼痛管理方案，该方案在股骨颈骨折半关节置换术后采用关节周围注射脂质体布比卡因。这项回顾性研究选择了在多模式疼痛管理方案（LBUP）中接受关节周围注射脂质体布比卡因的患者（n = 100）和未进行局部浸润治疗的对照组患者（n = 78）。两组在术后第1天至第4天实现了相似的疼痛控制（最小P = 0.392）。LBUP组患者的住院时间显著缩短（4.8天对5.7天，P = 0.013），并且LBUP组患者出院时能够走动的可能性显著更高（82%对69%，P = 0.013）。LBUP组患者也不太可能需要重症监护病房（4%对14%，P = 0.027）。LBUP组中至少发生一次阿片类药物相关不良事件的患者百分比更低（3%对8%，P = 0.156），90天死亡率也是如此（2%对8%，P = 0.069），但差异无统计学意义。（《外科骨科进展杂志》28(1):58 - 62，2019年）
