A Randomized Double-Blind Prospective Study Comparing the Efficacy of Subperiosteal and Periarticular Injections of a Local Anesthetic for Postoperative Pain Management after Total Knee Arthroplasty
محل انتشار: مجله استخوان و جراحی عمومی، دوره: 11، شماره: 11
سال انتشار: 1402
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 68
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شناسه ملی سند علمی:
JR_TABO-11-11_007
تاریخ نمایه سازی: 14 آبان 1402
چکیده مقاله:
Objectives: Total knee arthroplasty (TKA) serves as an effective surgical treatment method for advanced osteoarthritis (OA). Nonetheless, it is associated with postoperative pain that can influence patients’ functional outcome. This study aimed to compare the analgesic effect of subperiosteal and periarticular injection methods of a special local anesthetic in patients who underwent TKA.Methods: This double-blind prospective clinical study was conducted on patients with advanced knee OA who underwent TKA. Patients were randomly divided into two groups, with a local anesthetic (۲۱ ml) administered either in periarticular (P group) or subperiosteal (S group) forms prior to wound closure. The local anesthetic consisted of lidocaine ۲% (۱۵ cc), dexmedetomidine (۱ cc), and marcaine ۰.۵% (۵ cc). A study-blinded orthopedic resident recorded postoperative pain levels using a ۱۰-point visual analogue score (VAS) (۰ indicating no pain, ۱۰ indicating worst pain) at ۶, ۱۲, ۲۴, and ۴۸ hours after surgery.Results: A total of ۴۰ patients (P and S group; n=۲۰ each), consisting of ۱۰ males (mean age=۶۷.۴ years old), were included in this study. The intensity of pain in the S group was significantly lower than in the P group ۲۴ hours after surgery (mean VAS scores in the P group: ۴±۱ vs. the S group: ۳.۳±۰.۷, P=۰.۰۲۴). Furthermore, VAS scores at ۶, ۱۲, and ۴۸ hours post-surgery were lower in the S group compared to the P group; however, the difference was not statistically significant (P>۰.۰۵).Conclusion: Our study indicated that subperiosteal injection of lidocaine, dexmedetomidine, and marcaine is more effective than periarticular injection, providing effective postoperative pain management after TKA.Level of evidence: II
کلیدواژه ها:
نویسندگان
Reza Minaei
Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran/Bone Joint and Related Tissues Research Center, Akhtar
Mohammad Salehpour Roudsari
Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Emad Kouhestani
Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran/Bone Joint and Related Tissues Research Center, Akhtar
Mahshid Ghasemi
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences,Tehran, Iran
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