Fang Xiaoli, Zhao Yueping, Yao Yao, Qin Jianghui, Lin Yan, Yang Jin, Xu Ruijuan
China Pharmaceutical University Nanjing Drum Tower Hospital, Nanjing, China.
Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Front Pharmacol. 2024 Sep 20;15:1412099. doi: 10.3389/fphar.2024.1412099. eCollection 2024.
Total hip arthroplasty or total knee arthroplasty (THA/TKA) is often associated with varying degrees of pain. In recent years, transdermal buprenorphine (TDB) patch has shown encouraging results for acute postoperative pain control in orthopedic surgery. The aim of our study was to investigate the efficacy and safety of the combination of TDB patch and nonsteroidal anti-inflammatory drugs (NSAIDs) as a multimodal analgesic regimen after THA/TKA.
Patients who underwent THA and TKA between January 2022 and January 2023 were reviewed. Three postoperative analgesic regimens were selected: Group A (flurbiprofen 50 mg and tramadol 37.5 mg/acetaminophen 325 mg), Group B (flurbiprofen 50 mg and TDB 5 mg), and Group C (Parecoxib 40 mg and TDB 5 mg). The primary outcomes were the Wong-Baker face pain scale revision (FPS-R) scores and the rate of sleep disturbances. Secondary outcomes of the study included the proportion of patients with postoperative pain relief rates categorized as 0%, <50%, ≥50%, and 100%.
The dynamic FPS-R pain scores on day 3 after surgery in Group B were significantly lower than those in Group A for THA ( < 0.017). The dynamic FPS-R pain scores were lowest in Group C on day 2 and 3 after THA and TKA ( < 0.017). Rate of sleep disturbances was significantly lower in Group B for THA and in Group C for TKA, respectively, compared with that in Group A ( < 0.017). The proportion of dynamic pain relief rate ≥50% in Group C was statistically higher than that in Group A for THA ( < 0.017). Rate of adverse reactions among three groups for THA and TKA was not statistically different ( > 0.05).
This study suggests that the combination of TDB patch and NSAIDs is safe and effective for postoperative analgesia after THA/TKA.
全髋关节置换术或全膝关节置换术（THA/TKA）常伴有不同程度的疼痛。近年来，丁丙诺啡透皮贴剂（TDB）在骨科手术术后急性疼痛控制方面显示出令人鼓舞的效果。我们研究的目的是探讨TDB贴剂与非甾体抗炎药（NSAIDs）联合作为THA/TKA术后多模式镇痛方案的疗效和安全性。
回顾2022年1月至2023年1月期间接受THA和TKA的患者。选择三种术后镇痛方案：A组（氟比洛芬50mg和曲马多37.5mg/对乙酰氨基酚325mg）、B组（氟比洛芬50mg和TDB 5mg）和C组（帕瑞昔布40mg和TDB 5mg）。主要结局指标为面部表情疼痛评分修订版（FPS-R）得分和睡眠障碍发生率。研究的次要结局指标包括术后疼痛缓解率分为0%、<50%、≥50%和100%的患者比例。
THA术后第3天，B组的动态FPS-R疼痛评分显著低于A组（<0.017）。THA和TKA术后第2天和第3天，C组的动态FPS-R疼痛评分最低（<0.017）。THA中B组和TKA中C组的睡眠障碍发生率分别显著低于A组（<0.017）。THA中C组动态疼痛缓解率≥50%的比例在统计学上高于A组（<0.017）。THA和TKA三组的不良反应发生率无统计学差异（>0.05）。
本研究表明，TDB贴剂与NSAIDs联合用于THA/TKA术后镇痛是安全有效的。
