TKA: Similar pain outcomes for local infiltration anesthesia and continuous femoral block .
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):33 Acta Orthop. 2011 Aug;82(4):441-7. Epub 2011 May 1140 patients undergoing total knee arthroplasty with spinal anaesthesia were randomized to receive either a local infiltration of anaesthesia or a continuous femoral block. The primary outcome was pain at rest and at movement. The results at 24 hours postoperatively indicated both interventions produced comparable analgesic effect. Local infiltration of anaesthesia may be preferred, because it is more cost-effective and easier to execute.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
نعم = 1
غير مؤكد = 0.5
غير ذي صلة = 0
لا = 0
يقيّم تقييم معايير الإبلاغ الشفافية التي يبلغ بها المؤلفون عن الخصائص المنهجية والتجريبية للتجربة في المنشور. ينقسم التقييم إلى خمس فئات معروضة أدناه.
4/4
Randomization
2/4
Outcome Measurements
2/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
مؤشر الهشاشة هو أداة تساعد في تفسير النتائج المهمة، وتوفر مقياسًا لقوة النتيجة. ويمثل مؤشر الهشاشة عدد الأحداث المتتالية التي يجب إضافتها إلى نتيجة ثنائية التفرع لجعل النتيجة غير مهمة. يمثل الرقم الصغير نتيجة أضعف ويمثل الرقم الكبير نتيجة أقوى.
لماذا كانت هناك حاجة لهذه الدراسة الآن؟
Total knee arthroplasty (TKA) can produce severe postoperative pain, which may delay recovery. There are a number of pain treatments present, such as femoral nerve block or epidural analgesia. Local infiltration analgesia (LIA) has become a popular choice in pain management, but its effectiveness has yet to be fully evaluated. This study examines the outcomes of pain when patients undergoing total knee arthroplasty receive either a local infiltration of anaesthesia or a continuous femoral block.
ما هو سؤال البحث الرئيسي؟
What are the outcomes in pain with an intervention involving a peri- and intra-articular infiltration of anesthesia or a continuous femoral block in patients undergoing total knee arthroplasty at 24 hours postoperatively?
- The local infiltration anaesthesia group (Group LIA) reported lower average pain at rest compared to the femoral nerve block group. (Group F) (Group LIA: 1.6, Group F: 2.2)
- 7/19 patients in Group F reported a pain intensity of >7 upon movement compared to only 1/20 patients in Group LIA. (p=0.04, Fisher's exact test)
- Both groups indicated comparable consumption of morphine per kg. (Femoral block: 0.4 (0.3-0.5) mg/kg; LIA: 0.3 (0.2-0.4) mg/kg)
- No adverse events were reported within the 24 hour postoperative study period.
ما الذي يجب أن أتذكره أكثر؟
Both the local infiltration anaesthesia intervention and the femoral nerve block interventions provided good analgesic effect in patients after total knee arthroplasty. However, local infiltration anaesthesia may be a preferred option, because of its cost-effectiveness and ease of administration compared to the femoral nerve block.
كيف سيؤثر ذلك على رعاية مرضاي؟
Both local infiltration anaesthesia and femoral nerve block described in this study provide good analgesia following TKA. However, local infiltration anaesthesia may be a preferred treatment due to lower costs and the ease to perform this technique.
تنويه
هذا المحتوى الموجود في هذه الصفحة هو لأغراض إعلامية فقط وليس الغرض منه أن يكون بديلاً عن المشورة الطبية المتخصصة أو التشخيص أو العلاج. إذا كنت بحاجة إلى علاج طبي، اطلب دائمًا مشورة طبيبك أو اذهب إلى أقرب قسم طوارئ إليك. الآراء والمعتقدات ووجهات النظر التي يعبر عنها الأفراد في المحتوى الموجود في هذه الصفحة لا تعكس آراء ومعتقدات ووجهات نظر أورثوإيفيدنس.
0 من 4 مقالات مجانية شهرية غير مقفلة
