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局部酮咯酸浸润用于扳机指切开术后疼痛:一项随机对照试验。

Local ketorolac infiltration for postoperative pain in open trigger finger surgery: a randomized controlled trial.

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

BMC Musculoskelet Disord. 2024 Sep 17;25(1):746. doi: 10.1186/s12891-024-07856-6.

Abstract

BACKGROUND

Multimodal analgesia is crucial for effective postoperative pain management in minor hand surgeries, enhancing patient satisfaction. The use of local wound infiltration with Ketorolac as an adjuvant pain management strategy is proposed for open trigger finger release surgery. This study aims to compare pain scores and functional outcomes between local wound infiltration with Ketorolac and oral non-steroidal anti-inflammatory drugs.

METHODS

This study is a double-blind, parallel design, randomized controlled trials. Sixty-nine patients underwent trigger finger surgery between December 2021 and October 2022 were randomized into one of three groups: oral Ibuprofen alone group, local Ketorolac alone group and local Ketorolac with oral Ibuprofen group. The assessment included postoperative numeric rating scale (NRS) pain score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, grip strength, mobility of proximal interphalangeal (PIP) joint. and complications.

RESULTS

NRS pain scores during movement of the operated fingers were significantly lower at 6 h in local Ketorolac alone group and local Ketorolac with oral Ibuprofen group compared to oral Ibuprofen alone group. However, there were no significant differences between the groups in postoperative DASH scores, grip strength, mobility of PIP joints, and complications.

CONCLUSIONS

Local infiltration of Ketorolac as an adjunct in postoperative pain management has been shown to provide superior analgesia during finger movement within the initial 6 h following trigger finger surgery, in comparison to oral NSAIDs.

CLINICAL TRIAL REGISTRATION

Thaiclinicaltrials.org identifier: TCTR20210825002. Registered 25/08/2021. https://www.thaiclinicaltrials.org/show/TCTR20210825002.

摘要

背景

多模式镇痛对于手部小手术的有效术后疼痛管理至关重要,可以提高患者满意度。在开放性扳机指松解术中,建议使用局部伤口浸润酮咯酸作为辅助性疼痛管理策略。本研究旨在比较局部伤口浸润酮咯酸和口服非甾体抗炎药(NSAIDs)在疼痛评分和功能结果方面的差异。

方法

这是一项双盲、平行设计、随机对照试验。2021 年 12 月至 2022 年 10 月,69 例接受扳机指手术的患者被随机分为三组:单独口服布洛芬组、单独局部酮咯酸组和局部酮咯酸联合口服布洛芬组。评估包括术后数字评分量表(NRS)疼痛评分、上肢残疾问卷(DASH)评分、握力、近节指间关节(PIP)活动度和并发症。

结果

与单独口服布洛芬组相比,局部酮咯酸组和局部酮咯酸联合口服布洛芬组在术后 6 小时时手指活动时的 NRS 疼痛评分显著降低。然而,三组间术后 DASH 评分、握力、PIP 关节活动度和并发症无显著差异。

结论

与口服 NSAIDs 相比,局部浸润酮咯酸作为术后疼痛管理的辅助治疗,在扳机指手术后最初 6 小时内的手指运动中提供了更好的镇痛效果。

临床试验注册

泰国临床试验注册中心注册号:TCTR20210825002。注册日期:2021 年 8 月 25 日。网址:https://www.thaiclinicaltrials.org/show/TCTR20210825002。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1f0/11406808/0fbb5fe8a6f8/12891_2024_7856_Figa_HTML.jpg

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