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术前塞来昔布和加巴喷丁对全膝关节置换术后疼痛、功能恢复及生活质量影响的比较:一项随机对照临床试验

Comparison of the effects of preoperative celecoxib and gabapentin on pain, functional recovery, and quality of life after total knee arthroplasty: A randomized controlled clinical trial.

作者信息

Motififard Mehdi, Hatami Saeed, Feizi Awat, Toghyani Arash, Parhamfar Mohammad

机构信息

Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2023 Jun 12;28:50. doi: 10.4103/jrms.jrms_416_22. eCollection 2023.

Abstract

BACKGROUND

Acute pain is one of the main complaints of patients after total knee arthroplasty (TKA), which causes delayed mobility, increased morphine consumption, and subsequently increased costs. Therefore, the present study was performed to evaluate the preventive effect of preoperative celecoxib and gabapentin on reducing patient pain as a primary outcome after TKA surgery.

MATERIALS AND METHODS

This randomized, double-blind controlled clinical trial was performed on 270 patients with osteoarthritis that were candidates for TKA surgery allocated into three groups. In the first group, 900 mg of gabapentin was administered orally on a daily basis for 3 days before surgery. In the second group, 200 mg of oral celecoxib was administered twice daily for 3 days before surgery. In the third group, oral placebo was administered twice daily for 3 days before the surgery. The patients' pain score and knee and its functional score were recoded.

RESULTS

The mean of reduction pain in gabapentin and celecoxib groups was significantly lower than that of the control group at 12, 24, and 48 h after surgery ( < 0.001); however, two groups were not significantly different from each other ( > 0.05). Furthermore, the two medication groups were not significantly different in this regard ( > 0.05). In addition, the knee score in the gabapentin group with the means of 85.40 ± 5.47 and the celecoxib group with the means of 87.03 ± 3.97 were significantly higher than those of the control group with the means of 78.90 ± 4.39 in the 1 month after the surgery ( < 0.001).

CONCLUSION

According to the results of the present study, the preventive administration of gabapentin and celecoxib showed a significant and similar effectiveness on reducing patient pain after TKA surgery and on improving the KSS and quality of life scores.

摘要

背景

急性疼痛是全膝关节置换术(TKA)后患者的主要主诉之一,它会导致活动延迟、吗啡消耗量增加,进而增加成本。因此,本研究旨在评估术前塞来昔布和加巴喷丁对减轻TKA手术后患者疼痛这一主要结局的预防效果。

材料与方法

本随机、双盲对照临床试验对270例骨关节炎患者进行,这些患者均为TKA手术候选者,被分为三组。第一组在术前3天每天口服900毫克加巴喷丁。第二组在术前3天每天口服200毫克塞来昔布,每日两次。第三组在术前3天每天口服两次安慰剂。记录患者的疼痛评分以及膝关节及其功能评分。

结果

加巴喷丁组和塞来昔布组术后12、24和48小时的平均疼痛减轻程度显著低于对照组(P<0.001);然而,两组之间无显著差异(P>0.05)。此外,在这方面两个用药组也无显著差异(P>0.05)。另外,加巴喷丁组膝关节评分均值为85.40±5.47,塞来昔布组膝关节评分均值为87.03±3.97,均显著高于术后1个月对照组的膝关节评分均值78.90±4.39(P<0.001)。

结论

根据本研究结果,术前给予加巴喷丁和塞来昔布在减轻TKA手术后患者疼痛以及改善膝关节协会评分(KSS)和生活质量评分方面显示出显著且相似的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea3/10366981/e7af98d84b6a/JRMS-28-50-g001.jpg

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