Peri-Articular Multimodal Drug Injection Reduces Rescue Analgesia & Pain in Elbow Arthrolysis .
How effective is periarticular multimodal drug injection in open elbow arthrolysis? A prospective double-blind randomized controlled trial
J Shoulder Elbow Surg. 2021 Apr;30(4): 884-893.Fifty-nine patients scheduled to undergo open elbow arthrolysis were randomized to receive a periarticular multimodal drug injection (PMID; n=28) or control (no injection; n=31) immediately after the surgery for pain relief. The primary outcome of interest was elbow pain measured on a visual analogue scale (VAS) over the first post-operative week during rest and during motion. Other outcomes of interest included the use of rescue analgesia (i.e., parecoxib) and volume of draining blood loss which were both measured at days 1,2, and 3 post-surgery. Furthermore, incidence of complications, and range of motion up to 1 week post-surgery were also measured. Results revealed that VAS pain scores at rest were significantly lower in the PMID group vs control at days 1 to 3 post-surgery, but this trend was not observed for days days 4 to 7 (p>0.05 for all). For VAS pain during motion, scores were significantly lower in the PMID group compared to control from days 1 to 5 post-surgery (p<0.05 for all) but not at day 7 (p=0.196). Range of motion in the first 4 post-operative days and blood drainage volume on the 1st post-operative day were significantly in favour of the PMID group (p<0.05 for all).
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