在初级全膝关节整形术后,术后低剂量杜洛西丁是否提供止痛作用和降低吗啡消耗? 一个前性,双盲,随机对照试验
Piya Pinsornsak1, Jakkarin Phunphakchit1, Prem Pinsornsak2
1Department of Orthopaedic Surgery, Thammasat University, Pathum Thani, Thailand.
Archives of orthopaedic and trauma surgery
|September 30, 2024
概括
在全膝关节整形术 (TKA) 后,低剂量杜洛西丁 (30 mg/d) 减少了吗啡的使用,改善了膝关节功能得分. 虽然它没有显著减少整体疼痛,但它为TKA后的多模式疼痛管理提供了可容忍的辅助.
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:
- 杜洛西丁在全膝关节整形术 (TKA) 试验中显示出作为辅助止痛药的前景.
- 对于TKA后疼痛管理的杜洛西丁疗法缺乏标准化.
- 这项研究评估了低剂量杜洛西丁在TKA患者中的疗效.
研究的目的:
- 评估duloxetine 30 mg/d作为TKA后多模式止痛的辅助剂的止痛效果.
- 为了比较duloxetine和安慰剂组之间的疼痛评分,吗啡消耗和功能结果.
- 在TKA后的环境中评估低剂量杜洛西丁的安全性和耐受性.
主要方法:
- 一个双盲,随机对照试验,涉及接受单边初级TKA的患者.
- 对比30毫克/天的杜洛西丁6周与标准的多种模式止痛.
- 主要结局:多个时间点的疼痛视觉模拟量表 (VAS).
- 二次结局:吗啡消耗,不良事件,牛津膝盖评分,膝盖损伤和关节炎结局评分 (KOOS).
主要成果:
- 静脉神经系统疼痛在休息,行走或夜间没有显著差异,除了杜洛西丁组2周后的夜间下部疼痛外.
- 杜洛西丁组显示,平均总吗啡消耗量 (0-72小时) (p=0.04) 减少了33% (p=0.04).
- 在不良事件中没有显著差异;在杜洛西丁组中,在6周和12周改善了KOOS症状.
结论:
- 低剂量杜洛西丁 (30毫克/天) 有效地减少了手术后的吗啡消耗,并改善了TKA后的KOOS症状.
- 杜洛西丁并没有显著减少休息或行走期间的疼痛.
- 低剂量杜洛西丁是TKA后多模式疼痛管理策略的一个耐受良好补充.
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