ARTHROPLASTY
Comparison of peri- and intraarticular analgesia with femoral nerve block after total knee arthroplasty: A randomized clinical trial
この研究はハイインパクトの可能性があります。
OEのAI駆動型ハイインパクト指標は、論文が掲載されたジャーナルと論文自体の科学的内容の両方からのシグナルを統合することで、論文が持つ可能性の高い影響力を推定します。
最先端の自然言語処理を用いて開発されたOEハイインパクトモデルは、ジャーナルのインパクトファクターのみよりも、研究の将来の引用実績をより正確に予測します。
これにより、臨床的に意義のある研究をより早く認識することが可能になり、読者は将来の診療を形成する可能性が最も高い論文に集中することができます。
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):10 Acta Orthop. 2007 Apr;78(2):172-9.80 patients requiring total knee arthroplasty (TKA) were randomized to receive one of two treatments for managing postoperative TKA pain. One group received a periarticular injection of analgesic followed by intra-articular bolus injections, and the other group underwent a continuous femoral nerve block (a standard treatment for postoperative pain at the institution of study) followed by an infusion of a local anaesthetic. Results showed that the group receiving a periarticular injection of analgesics followed by bolus injections had lower pain scores and better mobilization compared to the group receiving the continuous nerve block treatment.
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)?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
3/4
Randomização
2/4
Medidas de resultado
4/4
Inclusão/Exclusão
4/4
Descrição do tratamento
4/4
Estatística
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
Postoperative pain management after total knee surgery often involves a combination of different modalities and can cause numerous side effects. Postoperative pain may delay recovery; therefore, alternative methods of analgesia are of interest to researchers. Recent studies suggest that periarticular infiltration of local anaesthetics may be an effective way to reduce postoperative pain. This study examined the effects of using a peri- and intra-articular analgesic treatment compared to femoral nerve block treatment in managing postoperative pain.
主な研究課題は何ですか？
What is the quality of analgesia and mobilization in patients requiring total knee arthroplasty undergoing peri- and intra-articular injections compared to a continuous femoral nerve block procedure from the end of surgery to postoperative day 3?
重要な知見は？
- More patients in Group I (peri- and intra-articular injection group) (29/39) were able to walk >3 m on the first day post-operation compared to the Group F (continuous femoral nerve block group) (7/37). (P<0.001)
- Group I showed lower pain scores (median: 3 compared to median:5) and opioid consumption (median: 83 mg compared to median: 100 mg) on the first day post-operation compared to Group F. (P=0.001 and P=0.02)
- More patients in Group I were able to hold quadriceps tension for >5 sec (30/37 compared to 18/36) and achieved flexion >90 degrees (24/39 compared to 18/37) compared to Group F on the first day post-operation. (P=0.002 and P=0.3)
- The length of stay between Group I and Group F in the recovery room were similar (Group F: 3.5h; Group I: 3.0h). (p=0.05)
- The median length of stay for Group I was 5 days, and for Group F was 6 days. (P=0.03)
- No significant difference was seen in the number of days each group experienced adverse effects. (P>0.20)
最も覚えておくべきことは？
Peri-articular injections of analgesics followed by intra-articular bolus injections can improve postoperative analgesia in patients undergoing total knee arthroplasty in comparison to a femoral nerve block.
それが私の患者ケアにどのように影響するか？
Use of peri- and intra-articular infiltration and injection may provide better postoperative pain management for patients undergoing total knee arthroplasty. Further studies are required to determine appropriate drug dosage and duration of treatment. It is also uncertain if patients may benefit from subsequent bolus injections after the morning of the first postoperative day.
免責事項
このページに記載されている内容は、情報提供のみを目的としたものであり、専門的な医療アドバイス、診断、治療の代わりとなるものではありません。治療が必要な場合は、必ず医師の診断を仰ぐか、最寄りの救急外来を受診してください。このページに記載されている内容に関して個人が表明した意見、信念、見解は、OrthoEvidenceの意見、信念、見解を反映するものではありません。
0の4 月間無料記事のロック解除
