West China hospital of sichuan university, Sichuan, Chengdu, China.
Hospital of Chengdu Office of people's Government of Tibetan Autonomous Region, Chengdu, China.
J Orthop Surg Res. 2024 Nov 2;19(1):712. doi: 10.1186/s13018-024-05193-x.
Vitamin c can relieve the pain after other diseases, but there are no studies on whether vitamin C can relieve the pain after hip replacement. The purpose of this paper is to study whether vitamin C can relieve the pain after total hip replacement.
In this prospective, double-blind, placebo-controlled, randomized trial, 100 patients receiving THA at our hospital were randomly assigned to vitamin c or control groups. During the operation, the vitamin C group will receive intravenous injection of 3 g vitamin C, and the control group will receive 3 g placebo. If the patient has postoperative pain, 10 ml subcutaneous injection of morphine will be required as a rescue analgesic. The primary outcome was the amount of postoperative injection of morphine as a rescue analgesic and expression of inflammatory factors, and the secondary outcome was postoperative pain and hip recovery as assessed by visual analog scale (VAS).
The dosage of subcutaneous injection of morphine was significantly reduced in vitamin C group. VAS pain scores at rest and exercise were lower in the vitamin C group 24 h after surgery, and hip motion was better 24 h after surgery, but there was no significant difference between the two groups 24 h after surgery.Nonetheless, the overall changes in morphine usage and VAS scores did not surpass the established minimal clinically important differences (10 mg for morphine consumption; 1.5 at rest and 1.8 during movement for VAS scores).
Adding intravenous vitamin c to multimodal analgesia significantly improved morphine consumption, VAS pain score, and functional recovery. However, it is recommended that single intravenous administration of vitamin C during the perioperative period may achieve better pain relief for patients after THA.
维生素 C 可以缓解其他疾病后的疼痛，但目前尚无研究表明维生素 C 是否可以缓解髋关节置换术后的疼痛。本文旨在研究维生素 C 是否可以缓解全髋关节置换术后的疼痛。
在这项前瞻性、双盲、安慰剂对照、随机试验中，将我院接受全髋关节置换术的 100 例患者随机分为维生素 C 组和对照组。手术过程中，维生素 C 组给予静脉注射 3g 维生素 C，对照组给予 3g 安慰剂。如果患者术后有疼痛，需要皮下注射 10ml 吗啡作为解救性镇痛药。主要结局是术后吗啡解救性镇痛药的用量和炎症因子的表达，次要结局是术后视觉模拟评分（VAS）评估的术后疼痛和髋关节恢复情况。
维生素 C 组皮下注射吗啡的剂量明显减少。术后 24 小时，维生素 C 组静息和运动时 VAS 疼痛评分较低，术后 24 小时髋关节活动度较好，但两组差异无统计学意义。然而，吗啡用量和 VAS 评分的总体变化均未超过既定的最小临床重要差异（吗啡用量 10mg；VAS 评分静息时 1.5，运动时 1.8）。
在多模式镇痛中加入静脉维生素 C 可显著减少吗啡用量、VAS 疼痛评分和功能恢复。然而，建议在围手术期单次静脉给予维生素 C 可能会为接受全髋关节置换术的患者提供更好的疼痛缓解效果。
