Zhang Qingchun, Fan Limei
Department of Anesthesiology, Jinxiang Hospital Affiliated to Jining Medical College, Shandong, China.
Medicine (Baltimore). 2020 Aug 28;99(35):e21881. doi: 10.1097/MD.0000000000021881.
Pain control after total knee arthroplasty has shown many advances; however, the optimal method remains controversial. The purpose of this present study is to assess the efficacy and safety of the addition of local infiltration analgesia to adductor canal block for pain control after primary total knee arthroplasty.
This prospective randomized controlled research was conducted from January 2018 to June 2019. All the patients and their family members signed the informed consent forms, and this work was authorized via the ethics committee of Jinxiang Hospital Affiliated to Jining Medical College (JXHP0024578). Inclusion criteria were 55 years old or older, who possess the physical status I-III of American Society of Anesthesiologists, and the body mass index in the range of 18 to 30 kg/m. Exclusion criteria were regional and/or neuroaxial anesthesia contraindications, the history of drug allergy involved in the research, neuropathic pain, as well as the chronic pain requiring opioid therapy. Seventy-two patients were divided into 2 groups randomly. Study group (n = 36) received both adductor canal block and local infiltration analgesia. Control group (n = 36) received adductor canal block alone. Primary outcome included postoperative pain score (visual analog scale 0 to 10 cm, in which 0 represents no pain and 10 represents the most severe imaginable pain). The measures of secondary outcome included the knee range of motion, opioid consumption, the hospital stay length as well as the postoperative complications (for instance, pulmonary embolism, deep vein thrombosis, and the wound infection). All the analyses were conducted through utilizing the SPSS for Windows Version 20.0.
The results will be shown in .(Table is included in full-text article.) CONCLUSION:: The study will provide more evidence on the combination use of adductor canal block and local infiltration analgesia in the treatment of pain after the total knee arthroplasty.
This study protocol was registered in Research Registry (researchregistry5832).
全膝关节置换术后的疼痛控制已取得诸多进展;然而,最佳方法仍存在争议。本研究的目的是评估在初次全膝关节置换术后,在内收肌管阻滞基础上加用局部浸润镇痛用于疼痛控制的有效性和安全性。
本前瞻性随机对照研究于2018年1月至2019年6月进行。所有患者及其家属均签署了知情同意书,本研究经济宁医学院附属金乡医院伦理委员会批准(JXHP0024578)。纳入标准为年龄55岁及以上,美国麻醉医师协会身体状况分级为I-III级,体重指数在18至30kg/m²之间。排除标准为区域和/或神经轴索麻醉禁忌证、研究中涉及的药物过敏史、神经性疼痛以及需要阿片类药物治疗 的慢性疼痛。72例患者被随机分为两组。研究组(n = 36)接受内收肌管阻滞和局部浸润镇痛。对照组(n = 36)仅接受内收肌管阻滞。主要结局指标包括术后疼痛评分(视觉模拟量表0至10cm,其中0表示无疼痛,10表示可想象的最严重疼痛)。次要结局指标包括膝关节活动范围、阿片类药物消耗量、住院时间以及术后并发症(如肺栓塞、深静脉血栓形成和伤口感染)。所有分析均使用SPSS for Windows 20.0版软件进行。
结果将在……中展示。(表格包含在全文中。)结论:本研究将为内收肌管阻滞和局部浸润镇痛联合用于全膝关节置换术后疼痛治疗提供更多证据。
本研究方案已在研究注册库(researchregistry5832)注册。