区域麻醉可减少胫骨骨折手术患者的住院阿片类药物需求，但对外出患者无影响。
Regional anesthesia improves inpatient but not outpatient opioid demand in tibial shaft fracture surgery.
机构信息
Department of Orthopaedic Surgery, Duke University Medical Center, 200 Trent Drive, Durham, NC, 27710, USA.
Duke University School of Medicine, Duke University Medical Center, 3710, Durham, NC, 27710, USA.
出版信息
Eur J Orthop Surg Traumatol. 2023 Oct;33(7):2921-2931. doi: 10.1007/s00590-023-03504-2. Epub 2023 Mar 13.
BACKGROUND
Patients undergoing operative treatment of tibial shaft fractures have considerable pain largely managed with opioids. Regional anesthesia (RA) has been increasingly used to reduce perioperative opioid use.
METHODS
This was a retrospective study of 426 patients that underwent operative treatment of tibial shaft fractures with and without RA. Inpatient opioid consumption and 90-day outpatient opioid demand were measured.
RESULTS
RA significantly decreased inpatient opioid consumption for 48 h post-operatively (p = 0.008). Neither inpatient use after 48 h nor outpatient opioid demand differed in patients with RA (p > 0.05).
CONCLUSIONS
RA may help with inpatient pain control and reduce opioid use in tibial shaft fracture.
LEVEL OF EVIDENCE
Level III, retrospective, therapeutic cohort study.
背景
接受胫骨骨干骨折手术治疗的患者存在大量疼痛，主要采用阿片类药物进行管理。区域麻醉（RA）已被越来越多地用于减少围手术期阿片类药物的使用。
方法
这是一项回顾性研究，纳入了 426 例接受胫骨骨干骨折手术治疗的患者，分为使用和不使用 RA 的两组。测量了住院期间阿片类药物的消耗和 90 天门诊阿片类药物的需求。
结果
RA 显著降低了术后 48 小时内的住院期间阿片类药物消耗（p=0.008）。但 RA 组患者在 48 小时后住院期间的使用或门诊阿片类药物需求并无差异（p>0.05）。
结论
RA 可能有助于控制胫骨骨干骨折患者的住院期间疼痛，并减少阿片类药物的使用。
证据等级
III 级，回顾性，治疗性队列研究。
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