Hou Junde, Li Wei, Chen Yongxue, Yang Liping, Li Liying, Zhao Lu
Department of Anesthesiology.
Department of Obstetrics and Gynecology, Handan Central Hospital, Handan, China.
Medicine (Baltimore). 2019 Oct;98(40):e17133. doi: 10.1097/MD.0000000000017133.
This study aimed to investigate the efficacy and safety between early preoperative administration and postoperative administration of oral meloxicam in patients underwent arthroscopic knee surgery (AKS).
Totally 296 patients with the intention to undergo AKS were recruited and randomly allocated as 1:1 ratio into early preoperative analgesia (EPA) group and postoperative analgesia (POA) group. Pain visual analog scale (VAS) score and severity (at rest and at flexion), patient global assessment (PGA) score, the consumption of rescue analgesia (pethidine), and adverse events were evaluated during the perioperation. And knee range of motion (ROM), International Knee Documentation Committee (IKDC) score, and Lysholm score were assessed at baseline and at 3 months after AKS.
Both pain VAS score and severity (at rest and at flexion) were decreased at 4, 8, and 12 hours, but similar at -24, -2, 24, 36, and 48 hours after AKS in EPA group compared with POA group. Besides, PGA score was lower at 4, 8, 12, and 24 hours, but similar at -24, -2, 36, and 48 hours after AKS in EPA group compared with POA group. As to the consumption of pethidine in perioperative period, it was decreased in EPA group compared with POA group. No difference was observed in knee ROM, IKDC score, Lysholm score, and adverse effects between EPA group and POA group.
Early preoperative administration of meloxicam was a superior approach in pain control compared with postoperative administration in treating patients underwent AKS.
本研究旨在调查接受膝关节镜手术(AKS)的患者术前早期口服美洛昔康与术后口服美洛昔康在疗效和安全性方面的差异。
共招募了296例拟行AKS的患者,并按1:1比例随机分为术前早期镇痛(EPA)组和术后镇痛(POA)组。在围手术期评估疼痛视觉模拟量表(VAS)评分及严重程度(静息时和屈曲时)、患者整体评估(PGA)评分、补救性镇痛药(哌替啶)的消耗量以及不良事件。在基线及AKS术后3个月评估膝关节活动范围(ROM)、国际膝关节文献委员会(IKDC)评分和Lysholm评分。
与POA组相比,EPA组在AKS术后4、8和12小时时疼痛VAS评分及严重程度(静息时和屈曲时)均降低,但在术后-24、-2、24、36和48小时时相似。此外,与POA组相比,EPA组在AKS术后4、8、12和24小时时PGA评分较低,但在术后-24、-2、36和48小时时相似。至于围手术期哌替啶的消耗量,EPA组低于POA组。EPA组和POA组在膝关节ROM、IKDC评分、Lysholm评分及不良反应方面未观察到差异。
在治疗接受AKS手术的患者时,与术后给药相比,术前早期给予美洛昔康在疼痛控制方面是一种更优的方法。