Chen Jian-Jiun, Wu Yun-Che, Hung Chuan-Yu, Lee Cheng-Hung, Wang Jun-Sing
Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
Department of Orthopedics, Taichung Veterans General Hospital, Taichung 407219, Taiwan.
Life (Basel). 2024 Aug 15;14(8):1018. doi: 10.3390/life14081018.
We investigated the effects of periarticular multimodal drug injection (PMDI) on postoperative pain control, patients' mobilization, and length of hospital stay in patients undergoing total knee arthroplasty (TKA). We retrospectively enrolled patients who underwent unilateral TKA between 2019 and 2020. The formula for PMDI included 0.5 mL epinephrine (1 mg/mL), 1 mL ketorolac (30 mg/mL), 0.5 mL morphine (10 mg/mL), and 20 mL bupivacaine hydrochloride (5 mg/mL), mixed with 60 mL normal saline. The outcomes of interest included (1) the amount of patient-controlled anesthesia (PCA) consumption in the first 24 h after the surgery, (2) early mobilization within 24 h after the surgery, and (3) the length of hospital stay. A total of 127 patients were analyzed. Compared with patients who did not receive PMDI, those who received PMDI had lower consumption of PCA in the first 24 h (β coefficient -29.9, 95% CI -51.9 to -7.9, = 0.008), higher odds of early mobilization within 24 h (odds ratio 8.263, 95% CI 3.041 to 22.453, < 0.001), and shorter length of hospital stay (β coefficient -0.705, 95% CI -1.158 to -0.252, = 0.003). We suggest that PMDI may be considered for patients undergoing TKA to improve the quality of care and shorten their length of hospital stay.
我们研究了关节周围多模式药物注射(PMDI)对全膝关节置换术(TKA)患者术后疼痛控制、患者活动能力及住院时间的影响。我们回顾性纳入了2019年至2020年间接受单侧TKA的患者。PMDI配方包括0.5毫升肾上腺素(1毫克/毫升)、1毫升酮咯酸(30毫克/毫升)、0.5毫升吗啡(10毫克/毫升)和20毫升盐酸布比卡因(5毫克/毫升),与60毫升生理盐水混合。感兴趣的结果包括:(1)术后首24小时内患者自控镇痛(PCA)的消耗量;(2)术后24小时内的早期活动能力;(3)住院时间。共分析了127例患者。与未接受PMDI的患者相比,接受PMDI的患者在术后首24小时内PCA消耗量更低(β系数-29.9,95%可信区间-51.9至-7.9,P = 0.008),术后24小时内早期活动的几率更高(优势比8.263,95%可信区间3.041至22.453,P < 0.001),住院时间更短(β系数-0.705,95%可信区间-1.158至-0.252,P = 0.003)。我们建议,对于接受TKA的患者,可考虑使用PMDI以提高护理质量并缩短住院时间。