Lu Bin, Tian Ai-Xian, Fan Zheng-Rui, Zhao Xing-Wen, Jin Hong-Zhen, Ma Jian-Xiong, Ma Xin-Long
Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin University, Tianjin 300050, China.
World J Orthop. 2025 Apr 18;16(4):104452. doi: 10.5312/wjo.v16.i4.104452.
In the management of postoperative pain following total joint arthroplasty (TJA), the use of nonsteroidal anti-inflammatory drugs, including acetaminophen, plays a key role in alleviating pain. However, the comparison between intravenous and oral acetaminophen administration in patients undergoing full joint replacement surgery remains controversial.
To assess the effectiveness of intravenous and oral acetaminophen in alleviating pain and supporting rehabilitation following TJA.
PubMed, Embase and the Cochrane Library were comprehensively searched to identify cohort studies. The effects of intravenous and oral acetaminophen for managing pain and supporting rehabilitation following TJA were analysed using randomized controlled trials. PRISMA guidelines were followed. The effectiveness of the administration routes was compared based on visual analogue scale (VAS) scores at 24 and 48 h, total morphine usage within 24 h, and total duration of hospital stay.
The meta-analysis included seven studies comparing intravenous acetaminophen groups and oral acetaminophen groups. The results demonstrated that oral acetaminophen was comparable to intravenous acetaminophen with regard to VAS scores at 24 h and 48 h ( = 0.76 and 0.08, respectively). The difference in total morphine use between the two groups was not significant ( = 0.22). However, the total hospital stay duration of the intravenous acetaminophen groups was significantly reduced compared to the oral acetaminophen groups ( = 0.0005), showing significant advantages in optimizing postoperative recovery and shortening hospitalisation time.
After TJA surgery, intravenous injection of acetaminophen can shorten hospitalisation time and is suitable for rapid analgesia, Oral administration has become the preferred choice for mild cases due to its convenience and economy, providing a basis for clinical drug selection.
在全关节置换术（TJA）后疼痛管理中，包括对乙酰氨基酚在内的非甾体类抗炎药的使用在缓解疼痛方面起着关键作用。然而，全关节置换手术患者静脉注射与口服对乙酰氨基酚的比较仍存在争议。
评估静脉注射和口服对乙酰氨基酚在TJA后缓解疼痛及支持康复方面的有效性。
全面检索PubMed、Embase和Cochrane图书馆以识别队列研究。使用随机对照试验分析静脉注射和口服对乙酰氨基酚在TJA后疼痛管理及支持康复方面的效果。遵循PRISMA指南。基于24小时和48小时的视觉模拟量表（VAS）评分、24小时内吗啡总用量以及住院总时长比较给药途径的有效性。
荟萃分析纳入了7项比较静脉注射对乙酰氨基酚组和口服对乙酰氨基酚组的研究。结果表明，口服对乙酰氨基酚在24小时和48小时的VAS评分方面与静脉注射对乙酰氨基酚相当（分别为 = 0.76和0.08）。两组间吗啡总用量差异不显著（ = 0.22）。然而，静脉注射对乙酰氨基酚组的总住院时长与口服对乙酰氨基酚组相比显著缩短（ = 0.0005），在优化术后恢复和缩短住院时间方面显示出显著优势。
TJA手术后，静脉注射对乙酰氨基酚可缩短住院时间，适用于快速镇痛，口服给药因其便利性和经济性已成为轻症患者的首选，为临床药物选择提供了依据。
