NYU Langone Health, New York, New York, U.S.A..
NYU Langone Health, New York, New York, U.S.A.
Arthroscopy. 2021 Feb;37(2):530-536. doi: 10.1016/j.arthro.2020.09.046. Epub 2020 Oct 10.
To determine whether postoperative acetaminophen reduced narcotic consumption following hip arthroscopy for femoroacetabular impingement.
This was a single-center randomized controlled trial. Opioid-naïve patients undergoing hip arthroscopy for femoroacetabular impingement were randomized into 2 groups. The control group received our institution's standard of care for postoperative pain control, 28 tablets of 5 mg/325 mg oxycodone-acetaminophen prescribed as 1 to 2 tablets every 6 hours as needed for pain, whereas the treatment group were prescribed 650 mg acetaminophen every 6 hours for pain, with 5 mg/325 mg oxycodone-acetaminophen prescribed for breakthrough pain. Patients were instructed to be mindful of taking no more than 3 g of acetaminophen in a 24-hour limit. If this limit was reached, oxycodone 5 mg would be prescribed. They were contacted daily and asked to report opioid use as well as their level of pain using the visual analog pain scale.
Our institution enrolled 86 patients, 80 of whom completed the study (40 control, 40 treatment). There were no statistically significant differences with respect to patient demographics and patient-specific factors between groups (age at time of surgery, sex, American Society of Anesthesiologists classification, or body mass index). In addition, there was no statistically significant difference with respect to visual analog scale pain between groups preoperatively (P = .64) or at 1-week follow up (P = .39). The treatment group did not use a statistically significant different number of narcotics than the control group throughout the first postoperative week (6.325 pills treatment vs 5.688 pills control, P = .237).
The findings of this randomized controlled trial suggest that postoperative acetaminophen may have no effect on reducing the number of narcotic pills consumed by opioid-naïve patients following hip arthroscopy in the setting of reduced opioid-prescribing on the part of orthopaedic surgeons. Furthermore, the results of this study suggest surgeons may reduce postoperative narcotic prescribing without reducing patient satisfaction following hip arthroscopy.
II randomized control trial.
确定髋关节镜检查治疗股骨髋臼撞击症术后使用醋氨酚是否减少阿片类药物的消耗。
这是一项单中心随机对照试验。接受髋关节镜检查治疗股骨髋臼撞击症的阿片类药物初治患者被随机分为 2 组。对照组接受我们机构标准的术后疼痛控制治疗，即开 28 片 5mg/325mg 羟考酮-对乙酰氨基酚，按需每 6 小时服用 1 至 2 片；治疗组则开 650mg 对乙酰氨基酚，每 6 小时服用 1 次，用于治疗疼痛，同时开 5mg/325mg 羟考酮-对乙酰氨基酚用于治疗爆发性疼痛。患者被指示注意在 24 小时内不要服用超过 3g 的对乙酰氨基酚。如果达到这个限制，将开 5mg 羟考酮。每天与患者联系，要求报告阿片类药物的使用情况以及他们使用视觉模拟疼痛量表的疼痛程度。
我们机构共纳入 86 例患者，其中 80 例完成了研究（对照组 40 例，治疗组 40 例）。两组患者的人口统计学和患者特定因素无统计学差异（手术时的年龄、性别、美国麻醉医师协会分类或体重指数）。此外，两组患者术前（P=0.64）或术后 1 周（P=0.39）的视觉模拟疼痛评分无统计学差异。在整个术后第一周，治疗组的阿片类药物使用量与对照组相比没有显著差异（治疗组 6.325 片，对照组 5.688 片，P=0.237）。
这项随机对照试验的结果表明，在骨科医生减少阿片类药物处方的情况下，髋关节镜术后使用醋氨酚可能不会减少阿片类药物初治患者的阿片类药物用量。此外，本研究结果表明，髋关节镜术后，外科医生可以减少阿片类药物的处方，而不会降低患者的满意度。
II 级随机对照试验。
