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术前服用加巴喷丁或术中使用酮咯酸是否会影响髋关节镜检查后的术后疼痛?

Does preoperative gabapentin or intraoperative ketorolac influence postoperative pain following hip arthroscopy?

作者信息

Meyer Alex M, Petrachaianan Krit, Glass Natalie A, Westermann Robert W

机构信息

Department of Orthopedics & Rehabilitation, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.

出版信息

J Hip Preserv Surg. 2023 Oct 31;10(3-4):166-172. doi: 10.1093/jhps/hnad031. eCollection 2023 Aug-Dec.

Abstract

Optimization of perioperative analgesia has important implications for patient satisfaction and short-term outcomes. This study's purpose is to assess if preoperative gabapentin or intraoperative ketorolac influences postoperative pain or time to discharge following hip arthroscopy. In total, 409 patients who underwent hip arthroscopic femoroplasty and/or acetabuloplasty with a single surgeon for femoroacetabular impingement were retrospectively reviewed (September 2017 to February 2021). The effect of preoperative gabapentin or intraoperative ketorolac on postoperative visual analog scale (VAS) pain scores, perioperative opioids in morphine milligram equivalents (MMEs), time in post-anesthesia care unit (PACU), second-stage recovery and time to discharge was assessed using unadjusted and adjusted -tests, and generalized linear models controlling for operative time, traction time, preoperative MME, intraoperative MME and postoperative MME were compared between the groups of gabapentin to no gabapentin and ketorolac to no ketorolac. There was no difference in first PACU VAS pain score, final PACU VAS score, VAS pain score prior to discharge, average VAS pain score or pain level on follow-up call in the unadjusted or adjusted analysis for the preoperative gabapentin or intraoperative ketorolac groups. Females had higher first PACU VAS pain score (6.05 versus 5.15  = 0.0026), final PACU VAS pain score (4.43 versus 3.90,  = 0.0045), final VAS pain score prior to discharge (3.87 versus 3.03,  < 0.001) and average postoperative pain score (4.60 versus 4.03,  < 0.001), but no difference in VAS pain score on follow-up call following surgery. Gabapentin or ketorolac was not associated with decreased VAS pain scores or time to discharge after hip arthroscopy.

摘要

围手术期镇痛的优化对患者满意度和短期预后具有重要意义。本研究的目的是评估术前加巴喷丁或术中酮咯酸是否会影响髋关节镜检查术后的疼痛或出院时间。总共回顾性分析了409例接受髋关节镜下股骨成形术和/或髋臼成形术以治疗股骨髋臼撞击症的患者,手术由同一位外科医生进行(2017年9月至2021年2月)。使用未校正和校正的检验评估术前加巴喷丁或术中酮咯酸对术后视觉模拟评分(VAS)疼痛评分、围手术期吗啡毫克当量(MME)的阿片类药物用量、麻醉后恢复室(PACU)停留时间、第二阶段恢复情况和出院时间的影响,并比较加巴喷丁组与非加巴喷丁组、酮咯酸组与非酮咯酸组之间控制手术时间、牵引时间、术前MME、术中MME和术后MME的广义线性模型。在术前加巴喷丁或术中酮咯酸组的未校正或校正分析中,首次PACU VAS疼痛评分、最终PACU VAS评分、出院前VAS疼痛评分、平均VAS疼痛评分或随访时的疼痛程度均无差异。女性的首次PACU VAS疼痛评分较高(6.05对5.15,=0.0026)、最终PACU VAS疼痛评分较高(4.43对3.90,=0.0045)、出院前最终VAS疼痛评分较高(3.87对3.03,<0.001)以及术后平均疼痛评分较高(4.60对4.03,<0.001),但术后随访时的VAS疼痛评分无差异。加巴喷丁或酮咯酸与髋关节镜检查后VAS疼痛评分降低或出院时间缩短无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2aea/10757415/e7ad85a9ed5a/hnad031f1.jpg

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