Knapik Derrick M, Tanenbaum Joseph E, Salata Michael J, Victoroff Brian N, Voos James E, Gillespie Robert J
Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, U.S.A.
University Hospitals Sports Medicine Institute, Cleveland, Ohio, U.S.A.
Arthrosc Sports Med Rehabil. 2023 Jul 13;5(4):100760. doi: 10.1016/j.asmr.2023.100760. eCollection 2023 Aug.
To investigate the association between changes in individual (anterior, lateral, and posterior) and overall deltoid compartment pressures and postoperative opioid consumption up to 14 days after primary double-row arthroscopic rotator cuff repair (ARCR).
In 113 consecutive patients undergoing primary double-row ARCR, anterior, lateral, and posterior deltoid compartment pressures were measured prior to incision and immediately after closure with a manometer. Postoperatively, all patients were provided with an identical rehabilitation protocol, quantity and dose of opioid tablets, and pain journal in which to record daily opioid consumption and visual analog scale pain scores for 14 days after surgery. The pain journals were collected at the first postoperative visit, and opioid consumption was calculated based on morphine equivalents. Statistical analysis was performed to determine the association between deltoid compartment pressures and opioid consumption postoperatively.
Sixty-nine percent of patients who met the inclusion criteria (74 of 107) returned the pain journals. The mean age at the time of surgery was 57.4 ± 8.8 years (range, 30-75 years), with female patients being significantly older ( = .03). The mean length of surgery was 71.7 ± 16.3 minutes. No significant association between increase in individual (anterior, lateral, or posterior) or mean overall compartment pressures and morphine equivalents of opioid consumption was appreciated on any postoperative day.
No significant correlation between increase in individual or overall deltoid compartment pressures after ARCR and postoperative opioid consumption in the immediate postoperative period was found in this study.
Level II, prospective cohort study.
探讨初次双排关节镜下肩袖修补术(ARCR)后14天内,个体(前侧、外侧和后侧)三角肌间隙压力变化及三角肌间隙总压力变化与术后阿片类药物消耗量之间的关联。
对113例连续接受初次双排ARCR的患者,在切开前和缝合后立即用压力计测量前侧、外侧和后侧三角肌间隙压力。术后,所有患者均接受相同的康复方案、阿片类片剂的数量和剂量,并配备疼痛日记,用于记录术后14天内每日的阿片类药物消耗量和视觉模拟评分疼痛分数。在术后首次随访时收集疼痛日记,并根据吗啡当量计算阿片类药物消耗量。进行统计分析以确定三角肌间隙压力与术后阿片类药物消耗量之间的关联。
符合纳入标准的患者中有69%(107例中的74例)返回了疼痛日记。手术时的平均年龄为57.4±8.8岁(范围30 - 75岁),女性患者年龄显著更大(P = .03)。平均手术时长为71.7±16.3分钟。在术后任何一天,均未发现个体(前侧、外侧或后侧)压力升高或平均总间隙压力升高与阿片类药物消耗量的吗啡当量之间存在显著关联。
本研究发现,ARCR后个体或三角肌间隙总压力升高与术后早期阿片类药物消耗量之间无显著相关性。
II级,前瞻性队列研究。