Cuenca-Llavall Marta, Pérez-Prieto Daniel, Santiveri Francisco J, Garcia Alfonso León, Marqués Fernando
Acta Orthop Belg. 2020 Mar;86(1):33-37.
To determine whether local infiltration analgesia by catheter infusion was superior to conventional analgesia in terms of postoperative pain control after THR. A randomized double-blind clinical trial was performed. There were four groups based on catheter placement and the infusion constituents : 1) Intraarticular catheter + anesthetics ; 2) Intraarticular catheter +placebo ; 3) Subfascial catheter + anesthetics ; 4) Subfascial catheter + placebo. The anesthetic infusion contained bupivacaine (bolus + continuous perfusion up to 36 hours). The placebo solution was physiological serum. The same conventional analgesic schedule was prescribed to all patients. Pain was evaluated by means of PCA shots and the VAS. Side effects, time to start rehabilitation and time to discharge were also analyzed. 100 patients (25 for group). Mean age was 67 years old (SD 12 y/o) and 53% were male. Mean PCA shots was 27 [range 2-87] and mean VAS was 1 [range 0-7]. No differences were found (p>0.05) when these variables were compared between the groups. The use of LIA with bupivacaine using a catheter infusion does not provide better pain control after THR.
为了确定在全髋关节置换术（THR）后，通过导管输注进行局部浸润镇痛在术后疼痛控制方面是否优于传统镇痛。进行了一项随机双盲临床试验。根据导管放置位置和输注成分分为四组：1）关节内导管+麻醉剂；2）关节内导管+安慰剂；3）筋膜下导管+麻醉剂；4）筋膜下导管+安慰剂。麻醉剂输注中含有布比卡因（推注+持续灌注长达36小时）。安慰剂溶液为生理血清。所有患者均采用相同的传统镇痛方案。通过患者自控镇痛（PCA）给药次数和视觉模拟评分法（VAS）评估疼痛。还分析了副作用、开始康复的时间和出院时间。100例患者（每组25例）。平均年龄为67岁（标准差12岁），53%为男性。平均PCA给药次数为27次[范围2 - 87次]，平均VAS评分为1分[范围0 - 7分]。在组间比较这些变量时未发现差异（p>0.05）。在THR后，使用布比卡因通过导管输注进行局部浸润麻醉并不能更好地控制疼痛。
