Department of Orthopedics and Traumatology, Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, 8 Zhongnan West Road, Wuxi, 214071, China.
Department of Respiratory, Kunshan Hospital Affiliated to Nanjing University of Chinese Medicine, Kunshan, China.
Ir J Med Sci. 2020 May;189(2):535-542. doi: 10.1007/s11845-019-02128-y. Epub 2019 Nov 15.
This study aimed to compare the efficacy and safety of pre-operative and post-operative meloxicam administration regarding post-operative pain control and knee joint function recovery in knee osteoarthritis (KOA) patients who underwent total knee arthroplasty (TKA).
Totally, 196 KOA patients who underwent TKA were consecutively enrolled and randomly assigned into pre-operative (N = 98) and post-operative administration group (N = 98) as 1:1 ratio. Pre-operative administration group received meloxicam 15 mg at 24 h pre-operation and 7.5 mg at 4 h, 24 h, 48 h, and 72 h post-operation, respectively. Post-operative administration group received meloxicam 15 mg at 4 h post-operation and 7.5 mg at 24 h, 48 h, and 72 h post-operation, respectively. Pain visual analog scale (VAS) at rest and at flexion, patient's global assessment (PGA), patient-controlled analgesia (PCA) consumption, hospital for special surgery (HSS), knee score, and adverse events were assessed.
Pre-operative meloxicam administration attenuated pain VAS score at rest at 6 h, 12 h, and 24 h; and pain VAS score at flexion at 6 h, 12 h, 24 h, and 48 h; as well as PGA score at 6 h, 12 h, 48 h post-TKA compared with post-operative meloxicam administration. Additional and total consumption of PCA were both decreased in pre-operative meloxicam administration group than post-operative meloxicam administration group, while HSS knee score at 3 months post-TKA was similar between pre-operative and post-operative meloxicam administration groups. Regarding safety, the incidence of adverse events was of no difference between the two groups.
Pre-operative administration of meloxicam might assist the post-operative pain management and care in KOA patients who underwent TKA.
本研究旨在比较术前和术后美洛昔康给药在接受全膝关节置换术(TKA)的膝骨关节炎(KOA)患者中对术后疼痛控制和膝关节功能恢复的疗效和安全性。
连续纳入 196 例接受 TKA 的 KOA 患者,并按 1:1 比例随机分为术前(N=98)和术后给药组(N=98)。术前给药组在术前 24 小时给予美洛昔康 15mg,在术后 4、24、48 和 72 小时分别给予 7.5mg。术后给药组在术后 4 小时给予美洛昔康 15mg,在术后 24、48 和 72 小时分别给予 7.5mg。评估静息和活动时的疼痛视觉模拟量表(VAS)、患者整体评估(PGA)、患者自控镇痛(PCA)消费、特种外科医院(HSS)、膝关节评分和不良反应。
术前美洛昔康给药可减轻术后 6、12 和 24 小时静息时疼痛 VAS 评分;术后 6、12、24 和 48 小时活动时疼痛 VAS 评分;以及术后 6、12、48 小时的 PGA 评分。与术后美洛昔康给药组相比,术前美洛昔康给药组 PCA 的总用量和追加用量均减少,而术后 3 个月时 HSS 膝关节评分在术前和术后美洛昔康给药组之间无差异。关于安全性,两组不良反应发生率无差异。
术前给予美洛昔康可能有助于接受 TKA 的 KOA 患者术后疼痛管理和护理。