Department of Anesthesiology and Pain Medical Center, First Affiliated Hospital of Jiaxing University, Jiaxing, 314001, China.
Pain Management Department, Chengfeng Hospital of Daqing Oilfield, Daqing, 163001, China.
Inflammopharmacology. 2021 Jun;29(3):651-659. doi: 10.1007/s10787-021-00792-0. Epub 2021 Apr 2.
This study aimed to compare the efficiency regarding postoperative pain control, consumption of rescue drug, patients' satisfaction and the safety of preoperative analgesia versus postoperative analgesia using non-steroidal anti-inflammatory drugs (NSAIDs) in patients who received arthroscopic knee surgery (AKS).
Four hundred and sixty-four patients who received AKS were recruited in this multicenter, randomized, controlled study. Subsequently, they were randomized into PRE group (N = 232) and POST group (N = 232). In PRE group, patients received celecoxib, meloxicam or rofecoxib from 2 h pre-operation (Pre (- 2 h)) to 48 h post-operation for analgesia. In POST group, patients received celecoxib, meloxicam or rofecoxib from 4 to 48 h post-operation for analgesia.
h and 12 h; pain VAS at passive movement was reduced in PRE group than POST group at 6 h, 12 h and 24 h. Additionally, consumption of rescue drug (pethidine) was decreased, while overall satisfaction was increased in PRE group compared to POST group. As for adverse events, the incidences of nausea, vomiting, constipation, drowsiness and dizziness were similar between PRE group and POST group. In subgroup analysis, the pain VAS score at passive movement at 6 h and nausea and constipation incidences were distinctive among subgroups categorized by meloxicam, celecoxib and rofecoxib administration. However, no difference of other assessments was found among subgroups categorized by meloxicam, celecoxib and rofecoxib administration.
Preoperative analgesia using NSAIDs is more efficient and equivalently tolerable compared to postoperative analgesia using NSAIDs in patients who receive AKS.
本研究旨在比较膝关节镜手术（AKS）患者接受术前和术后使用非甾体抗炎药（NSAIDs）镇痛的术后疼痛控制效果、补救药物消耗、患者满意度和安全性。
本多中心、随机、对照研究共纳入 464 例接受 AKS 的患者。随后，他们被随机分为 PRE 组（n=232）和 POST 组（n=232）。在 PRE 组中，患者从术前 2 小时（Pre（-2 h））至术后 48 小时接受塞来昔布、美洛昔康或罗非昔布镇痛。在 POST 组中，患者从术后 4 小时至 48 小时接受塞来昔布、美洛昔康或罗非昔布镇痛。
与 POST 组相比，PRE 组在术后 6 小时、12 小时和 24 小时时的静息和被动运动时疼痛 VAS 评分降低，补救药物（哌替啶）消耗减少，总体满意度增加。对于不良事件，PRE 组与 POST 组的恶心、呕吐、便秘、嗜睡和头晕发生率相似。在亚组分析中，根据美洛昔康、塞来昔布和罗非昔布的给药情况，PRE 组在术后 6 小时的被动运动时疼痛 VAS 评分和恶心、便秘发生率与 POST 组存在差异。然而，在根据美洛昔康、塞来昔布和罗非昔布的给药情况进行亚组分析时，其他评估指标没有差异。
与术后使用 NSAIDs 镇痛相比，AKS 患者术前使用 NSAIDs 镇痛更有效且耐受性相当。
