与静脉注射相比,局部使用特兰胺酸可以减少阿片类药物的消耗,对于接受初级关节整形手术的患者:一项前性随机对照试验
Lei Shen1,2, Zhenhuan Jiang2, Qiang Wang2
1Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, 1055 Road Sanxiang, Suzhou, Jiangsu, 215004, China.
BMC musculoskeletal disorders
|June 3, 2023
概括
与静脉注射的TXA相比,局部使用的tranexamic acid (TXA) 显著减少了关节整形术 (THA) 后的早期关节疼痛和阿片类药物使用. 这是通过缓解早期的术后炎症反应来实现的,为疼痛管理提供了一种新的方法.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 在全关节整形术 (THA) 后,阿片类药物成是一个重大问题.
- 众所周知,胺酸 (TXA) 可以减少THA的血液损失,但它对术后疼痛的影响研究较少.
- 早期术后疼痛和炎症是影响康复和阿片类药物依赖的关键因素.
研究的目的:
- 评估局部TXA在减少初级THA患者早期术后部疼痛方面的疗效.
- 为了确定局部TXA是否可以降低阿片类药物消费.
- 为了研究局部疼痛和THA后的炎症反应之间的关系.
主要方法:
- 一项前性随机受控研究,涉及161名初级THA患者.
- 患者被分为局部TXA (n=79) 和静脉TXA (n=82) 组.
- 通过视觉模拟量表 (VAS) 评估疼痛,记录了阿片类药物使用 (特拉马多尔),并测量了炎症标志物 (CRP,ESR,IL-6).
主要成果:
- 与静脉注射组相比,局部TXA组在术后第一天表现出明显较低的VAS疼痛评分和炎症标志物 (P<0.05).
- 第一天的VAS得分与炎症标志物水平正相关 (P<0.05).
- 在手术后的第一天和第二天,局部用特拉马多尔的摄入量较低,在血液流失或并发症方面没有显著差异.
结论:
- 局部TXA有效地缓解了初级THA患者的早期术后部疼痛.
- 局部TXA通过减轻早期炎症反应来降低阿片类药物需求.
- 这种方法为增强疼痛控制和减少THA后阿片类药物依赖提供了一个有希望的策略.
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