与初次全膝关节置换术相比，翻修全膝关节置换术在术后急性期的阿片类药物消耗量显著更高。
Revision Total Knee Arthroplasty Is Associated With Significantly Higher Opioid Consumption as Compared With Primary Total Knee Arthroplasty in the Acute Postoperative Period.
作者信息
Bernstein Jenna, Feng James, Mahure Siddharth, Schwarzkopf Ran, Long William
机构信息
NYU Langone, Department of Orthopedics - Division of Adult Joint Reconstruction, New York, NY, USA.
Insall-Scott-Kelly Institute, New York, NY, USA.
出版信息
Arthroplast Today. 2020 May 11;6(2):172-175. doi: 10.1016/j.artd.2020.04.001. eCollection 2020 Jun.
BACKGROUND
There is a scarcity of studies investigating narcotic use after revision total knee arthroplasty (TKA). We compared immediate postsurgical narcotic consumption after revision TKA and primary TKA.
METHODS
A single-institution database was used to identify patients who underwent revision TKA or primary TKA between 2016 and 2019. Morphine milligram equivalents (MMEs) were calculated to discern narcotic usage, and pain visual analog score was also used.
RESULTS
A total of 7342 cases were identified: 88.65% primary TKA and 11.35% revision TKA. Opioid consumption for the first 24 hours postoperatively was significantly higher for the revision TKA group (133.1 MMEs vs 56.14 MMEs, < .0001), as well as for the 24- to 48-hour time period. The visual analog pain scores were also higher for the revision TKA group.
CONCLUSION
The revision TKA group had a higher opioid requirement, most significant during the first 24 hours postoperatively, and expressed more pain in the acute postoperative period.
背景
关于全膝关节置换术（TKA）翻修术后麻醉药物使用情况的研究较少。我们比较了TKA翻修术和初次TKA术后即刻的麻醉药物消耗量。
方法
使用单机构数据库识别2016年至2019年间接受TKA翻修术或初次TKA的患者。计算吗啡毫克当量（MMEs）以辨别麻醉药物使用情况，并使用疼痛视觉模拟评分。
结果
共识别出7342例病例：88.65%为初次TKA，11.35%为TKA翻修术。TKA翻修术组术后24小时内的阿片类药物消耗量显著更高（133.1 MMEs对56.14 MMEs，<0.0001），24至48小时时间段也是如此。TKA翻修术组的视觉模拟疼痛评分也更高。
结论
TKA翻修术组对阿片类药物的需求量更高，在术后最初24小时最为显著，且在术后急性期疼痛更明显。
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