ARTHROPLASTY
Perioperative celecoxib administration for pain management after total knee arthroplasty: A randomized, controlled study
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(2):61 BMC Musculoskelet Disord. 2008 Jun 3;9:7780 patients (>60 yr of age) scheduled to undergo total knee arthroplasty were randomized to receive either patient controlled morphine analgesia (PCA) or a combination of PCA and perioperative oral celecoxib. Perioperative celecoxib administration along with PCA, demonstrated better results in terms of visual analog scale (VAS) pain scores, active range of motion (ROM) and total opioid usage.
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
4/4
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？
Many studies have suggested the use of non-steroidal anti-inflammatory drugs (NSAID) for multimodal postoperative pain management. The NSAIDs are a growing family of medications, with newer drugs associated with fewer side effects being developed. This study investigated the effects of NSAIDs on opioid-sparing and rehabilitation outcomes after perioperative celecoxib administration for total knee arthroplasty.
主な研究課題は何ですか？
Does the additional perioperative oral celecoxib administration to PCA improve the post-operative pain and active range of motion, while reducing total opioid use compared to PCA alone, as evaluated over 7 days?
重要な知見は？
- VAS Pain Scores: The intervention patients demonstrated less pain at 48 hrs compared to control group (2.13 ± 1.68 vs. 3.43 ± 1.50, p=0.03)
- VAS Pain Scores: At 72 hrs, the intervention group again demonstrated a reduced score: (1.78 ± 1.66 vs. 3.17 ± 2.01, p=0.02)
- Opioid requirements: Intervention group had a 40% decrease in total consumption compared to the control group (p=0.03)
最も覚えておくべきことは？
Perioperative oral celecoxib administration along with PCA improved postoperative resting pain scores at 48 and 72 hrs, and total opioid consumption after TKA compared to PCA alone.
それが私の患者ケアにどのように影響するか？
Perioperative celecoxib can be a useful addition in multi-modal pain management after total knee arthroplasty along with morphine PCA. Studies with larger populations should be conducted to confirm the findings.
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
