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关节镜下肩袖修复术后的疼痛控制:静脉注射对乙酰氨基酚与肌间沟臂丛神经阻滞的比较;一项前瞻性随机研究。

Post-operative pain control following arthroscopic rotator cuff repair: Intravenous acetaminophen versus interscalene brachial plexus block; A prospective randomized study.

作者信息

Takahashi Ryosuke, Kajita Yukihiro, Harada Yohei, Iwahori Yusuke, Deie Masataka

机构信息

Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Japan.

Department of Orthopaedic Surgery, Aichi Medical University, Japan.

出版信息

J Orthop. 2021 Mar 30;25:6-9. doi: 10.1016/j.jor.2021.03.010. eCollection 2021 May-Jun.

Abstract

BACKGROUND

With the increasing number of patients undergoing arthroscopic rotator cuff repair (ARCR), postoperative pain control in these patients has become an important issue. We investigated and compared post-operative pain relief with intravenous acetaminophen (IA) and interscalene brachial plexus block (IBPB) after ARCR.

METHODS

This prospective study involved 66 consecutive patients who underwent ARCR in 2019-2020 at our hospital. Overall, 23 and 43 shoulders were assigned to the IA and IBPB groups, respectively. We evaluated the visual analog scale (VAS) pain scores at rest, during activity, and at night for the first 72 h postoperatively. We compared the results statistically between the groups. A p-value <0.05 was considered statistically significant.

RESULTS

VAS scores for night pain in the IBPB group were significantly lower than those in the IA group for the first 24 h postoperatively (p = 0.017). In contrast, the same scores were significantly lower in the IA group than in the IBPB group at 72 h postoperatively (p = 0.024). Other scores were not significantly different between the groups.

CONCLUSIONS

IBPB provides superior night pain control during the first 24 h postoperatively, and IA provides superior night pain control at 72 h postoperatively. However, there were no significant differences in other pain scores between the two groups.

摘要

背景

随着接受关节镜下肩袖修补术(ARCR)的患者数量不断增加,这些患者术后的疼痛控制已成为一个重要问题。我们对ARCR术后静脉注射对乙酰氨基酚(IA)和肌间沟臂丛神经阻滞(IBPB)后的疼痛缓解情况进行了调查和比较。

方法

这项前瞻性研究纳入了2019年至2020年在我院连续接受ARCR的66例患者。总体而言,分别有23例和43例肩部被分配到IA组和IBPB组。我们评估了术后前72小时休息时、活动时和夜间的视觉模拟量表(VAS)疼痛评分。我们对两组结果进行了统计学比较。p值<0.05被认为具有统计学意义。

结果

术后第1个24小时,IBPB组的夜间VAS评分显著低于IA组(p = 0.017)。相比之下,术后72小时时,IA组的相同评分显著低于IBPB组(p = 0.024)。两组之间的其他评分无显著差异。

结论

IBPB在术后第1个24小时提供更好的夜间疼痛控制,而IA在术后72小时提供更好的夜间疼痛控制。然而,两组之间的其他疼痛评分无显著差异。

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