关节周围鸡尾酒式术中注射对全膝关节置换术后疼痛控制及膝关节活动恢复的有效性
Effectiveness of intraoperative periarticular cocktail injection for pain control and knee motion recovery after total knee replacement.
作者信息
Sreedharan Nair Vijayamohan, Ganeshan Radhamony Niranj, Rajendra Riju, Mishra Rahul
机构信息
Aster Orthopaedics and Rheumatology, Aster Medcity Hospital, Kochi, Kerala, India.
Department of Orthopaedics, Siddharth Hospital, Nepal Gunj, Nepal.
出版信息
Arthroplast Today. 2019 Jul 12;5(3):320-324. doi: 10.1016/j.artd.2019.05.004. eCollection 2019 Sep.
Abstract
BACKGROUND
Pain control after total knee replacement (TKR) is pivotal in postoperative rehabilitation. Usage of epidural analgesia or parenteral opioids can cause undesirable side effects hampering early recovery and rehabilitation. These side effects can be avoided by infiltration of an analgesic cocktail locally. Our study was performed to evaluate the benefits of a particular cocktail combination in patients undergoing TKR with respect to pain and knee motion recovery.
METHODS
One hundred consecutive patients who underwent simultaneous bilateral TKR were enrolled and received an intraoperative periarticular cocktail injection in the right knee (intervention) and normal saline in the left knee (control). Postoperative pain was recorded using the visual analog scale for each knee, and the time taken to achieve 90° of knee flexion was noted for each side.
RESULTS
The cocktail injected knee had significantly less pain when compared with the control knee during the first 48 hours and significantly shorter period to achieve 90° of knee flexion.
CONCLUSIONS
The use of intraoperative periarticular cocktail injection significantly reduces early postoperative pain and provides better early knee motion.
摘要
背景
全膝关节置换术（TKR）后的疼痛控制在术后康复中至关重要。硬膜外镇痛或胃肠外使用阿片类药物会产生不良副作用，阻碍早期恢复和康复。通过局部注射镇痛合剂可避免这些副作用。我们开展这项研究以评估一种特定合剂组合对接受TKR的患者在疼痛和膝关节活动恢复方面的益处。
方法
连续纳入100例接受同期双侧TKR的患者，右侧膝关节接受术中关节周围合剂注射（干预组），左侧膝关节注射生理盐水（对照组）。使用视觉模拟量表记录每个膝关节的术后疼痛情况，并记录每侧达到膝关节90°屈曲所需的时间。
结果
在前48小时内，注射合剂的膝关节与对照膝关节相比疼痛明显减轻，达到膝关节90°屈曲的时间明显缩短。
结论
术中关节周围注射合剂可显著减轻术后早期疼痛，并能使膝关节早期活动情况更佳。
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本文引用的文献
1
A state-of-the-art pain protocol for total knee replacement.
Arthroplast Today. 2016 Feb 12;2(1):23-25. doi: 10.1016/j.artd.2016.01.004. eCollection 2016 Mar.
2
Local Infiltration Analgesia reduces pain and hospital stay after primary TKA: randomized controlled double blind trial.
Acta Orthop Belg. 2015 Dec;81(4):720-9.
3
Periarticular regional analgesia in total knee arthroplasty: a review of the neuroanatomy and injection technique.
Orthop Clin North Am. 2015 Jan;46(1):1-8. doi: 10.1016/j.ocl.2014.09.016.
4
Controlling pain after total knee arthroplasty using a multimodal protocol with local periarticular injections.
J Orthop. 2013 Mar 17;10(2):92-4. doi: 10.1016/j.jor.2013.02.001. eCollection 2013.
5
Efficacy of multimodal perioperative analgesia protocol with periarticular medication injection in total knee arthroplasty: a randomized, double-blinded study.
J Arthroplasty. 2013 Sep;28(8):1274-7. doi: 10.1016/j.arth.2013.03.008. Epub 2013 Apr 20.
6
Periarticular injection with bupivacaine for postoperative pain control in total knee replacement: a prospective randomized double-blind controlled trial.
Adv Orthop. 2012;2012:107309. doi: 10.1155/2012/107309. Epub 2012 Oct 22.
7
Multimodal periarticular injection vs continuous femoral nerve block after total knee arthroplasty: a prospective, crossover, randomized clinical trial.
J Arthroplasty. 2012 Jun;27(6):1234-8. doi: 10.1016/j.arth.2011.12.021. Epub 2012 Feb 8.
8
Effect of a perioperative intra-articular injection on pain control and early range of motion following bilateral TKA.
Orthopedics. 2011 May 18;34(5):354. doi: 10.3928/01477447-20110317-11.
9
Analgesic efficacy of subcutaneous local anaesthetic wound infiltration in bilateral knee arthroplasty: a randomised, placebo-controlled, double-blind trial.
Acta Anaesthesiol Scand. 2010 May;54(5):543-8. doi: 10.1111/j.1399-6576.2009.02196.x. Epub 2010 Jan 6.
10
Efficacy of periarticular injection of bupivacaine, fentanyl, and methylprednisolone in total knee arthroplasty:a prospective, randomized trial.
J Arthroplasty. 2010 Sep;25(6):851-7. doi: 10.1016/j.arth.2009.09.007. Epub 2009 Dec 21.
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