Yang Ning, Wuhuzi Wulamu, Guo Xiaobin, Li Yicheng, Zhang Xiaogang
Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Mar 15;39(3):314-319. doi: 10.7507/1002-1892.202412024.
To investigate the analgesic effect of locally injecting a "cocktail" analgesia containing a high-dose compound betamethasone during revision hip arthroplasty, and also to study the usage of opioid drugs.
A retrospective analysis was conducted on the clinical data of 180 patients who underwent revision hip arthroplasty due to aseptic loosening of the hip prosthesis between January 2015 and December 2021. Among them, 95 patients received intraoperative injection of "cocktail" analgesia containing high-dose compound betamethasone (group A), and 85 patients received intraoperative injection of traditional "cocktail" analgesia (group B). There was no significant difference in baseline data such as gender, age, body mass index, presence or absence of diabetes mellitus between the two groups ( >0.05). The hospital stay, use of opioid drugs within 72 hours, and the incidence of adverse reactions within 72 hours after operation [including nausea and vomiting, insomnia, deep venous thrombosis (DVT), infection, .] were recorded and compared between the two groups. The pain relief of patients was evaluated using the static and dynamic visual analogue scale (VAS) scores at 12, 24, 48, and 72 hours after operation. The incidence of complications (including prosthesis re-loosening, hip joint dislocation, hip joint stiffness, limping, chronic pain, ) at 2 years after operation was recorded, and the Harris Hip Score (HHS) was used to evaluate the function at 2 years after operation.
In group A, the utilization rate of opioid drugs within 72 hours after operation was significantly lower than that in group B ( <0.05). However, there was no significant difference between the two groups in terms of hospital stay, as well as the incidence of adverse reactions such as nausea and vomiting, insomnia, DVT, and infection within 72 hours after operation ( >0.05). The VAS scores of both groups decreased with time, and the differences between different time points were significant ( <0.05). The static and dynamic VAS scores of group A were significantly lower than those of group B at 12, 24, and 48 hours after operation ( <0.05), but there was no significant difference in static and dynamic VAS scores between the two groups at 72 hours after operation ( >0.05). All patients in both groups were followed up 2-8 years, with an average of 5.73 years. At 2 years after operation, no significant difference was found between the two groups in the incidence of complications and HHS score ( >0.05).
"Cocktail" analgesia containing a high-dose compound betamethasone for early analgesia after revision hip arthroplasty can effectively reduce postoperative pain and the use of opioid drugs, but will not increase the incidence of infection and DVT after operation.
探讨在髋关节翻修术中局部注射含大剂量复方倍他米松的“鸡尾酒”镇痛方案的镇痛效果，并研究阿片类药物的使用情况。
回顾性分析2015年1月至2021年12月因髋关节假体无菌性松动而行髋关节翻修术的180例患者的临床资料。其中，95例患者术中注射含大剂量复方倍他米松的“鸡尾酒”镇痛方案（A组），85例患者术中注射传统“鸡尾酒”镇痛方案（B组）。两组患者的性别、年龄、体重指数、是否患有糖尿病等基线资料比较，差异无统计学意义（>0.05）。记录并比较两组患者的住院时间、术后72小时内阿片类药物的使用情况以及术后72小时内不良反应的发生率[包括恶心呕吐、失眠、深静脉血栓形成（DVT）、感染等]。采用术后12、24、48和72小时的静态和动态视觉模拟评分（VAS）评估患者的疼痛缓解情况。记录术后两年并发症（包括假体再松动、髋关节脱位、髋关节僵硬、跛行、慢性疼痛等）的发生率，采用Harris髋关节评分（HHS）评估术后两年的髋关节功能。
A组术后72小时内阿片类药物的使用率显著低于B组（<0.05）。然而，两组患者的住院时间以及术后72小时内恶心呕吐、失眠、DVT和感染等不良反应的发生率比较，差异无统计学意义（>0.05）。两组患者的VAS评分均随时间下降，不同时间点差异有统计学意义（<0.05）。术后12、24和48小时，A组的静态和动态VAS评分均显著低于B组（<0.05），但术后72小时两组的静态和动态VAS评分差异无统计学意义（>
