ARTHROPLASTY
Postoperative analgesia in total hip arthroplasty: A randomized double-blinded, placebo-controlled study on peroperative and postoperative ropivacaine, ketorolac, and adrenaline wound infiltration
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):9 Acta Orthop. 2007 Apr;78(2):187-9240 patients undergoing total hip replacement (THR) surgery were randomized into two groups to examine the outcomes of pain and postoperative requirement for analgesia. Both groups received wound infiltration at the end of surgery as well as through an intraarticular catheter 24 hours postoperatively, and both were blinded to treatment. The intervention group received a solution of ketorolac, ropivacaine and adrenaline, while the control group received a saline solution. Results showed that the intervention group had less pain up to 2-weeks postoperatively and were more satisfied compared to the control group. Patients receiving the analgesic also had less joint stiffness and better function at 1 week postoperatively.
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。
4/4
Randomização
3/4
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？
Pain management and comfort are important factors for optimal mobilization after total hip replacement (THR) surgery. Postoperative pain can prolong immobilization and hospital stay, so it is important for patients to receive an effective postoperative analgesic. This study examined double wound (operative and postoperative) infiltration with analgesia in patients undergoing THR surgery.
主な研究課題は何ですか？
Does the use of double (operative and postoperative) infiltration of analgesia result in decreased pain and faster mobilization after total hip replacement surgery?
重要な知見は？
- The intervention group had significantly less pain compared to the control group up to 2 weeks postoperatively.
- The intervention group had a lower use of analgesics up to the fourth postoperative day.
- The intervention group had better physical function (WOMAC physical function subscale) (p=0.02) and less joint stiffness (WOMAC joint stiffness subscale) (p=0.04) at 1 week postoperatively, but no significant differences were seen at 2, 4, and 6 weeks.
- Patients from the intervention group were discharged from the hospital at a median of 2.6 days compared to 2.8 days for the control group. (P>0.05)
- There was a statistically significant difference in patient satisfaction between the intervention and control group, with greater satisfaction seen in the intervention group 8 hours postoperatively (16 patients compared to 8; p<0.05), on day 1 (15 patients compared to 6; p<0.05) and in weeks 1, 2 and 4.
- No adverse effects were seen from the treatment group.
最も覚えておくべきことは？
Peroperative and postoperative wound infiltration of analgesia reduces pain as well as the analgesic requirement after total hip replacement surgery. This may allow for faster postoperative mobilization.
それが私の患者ケアにどのように影響するか？
Patients receiving double wound infiltration of analgesia may have faster mobilization postoperatively after total hip replacement surgery. Patients may also be more satisfied postoperatively when receiving the double wound infiltration procedure compared to the control group. There is interest in performing further studies to examine different study designs, such as continuous or frequent injections
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
