|本期目录/Table of Contents|

[1]袁涛,杨少强,赖圳登,等.“鸡尾酒”疗法对肩袖损伤修补术后镇痛的疗效影响[J].医学研究与战创伤救治(原医学研究生学报),2022,24(4):345-349.[doi:10.3969/j.issn.1672-271X.2022.04.003]
 YUAN Tao,YANG Shao-qiang,LAI Cheng-Teng,et al.Effect of cocktail injection therapy on postoperative analgesia of rotator cuff injury repair[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(4):345-349.[doi:10.3969/j.issn.1672-271X.2022.04.003]
点击复制

“鸡尾酒”疗法对肩袖损伤修补术后镇痛的疗效影响()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年4期
页码:
345-349
栏目:
临床研究
出版日期:
2022-08-30

文章信息/Info

Title:
Effect of cocktail injection therapy on postoperative analgesia of rotator cuff injury repair
作者:
袁涛杨少强赖圳登钱洪鱼鑫江辉孟嘉包倪荣
作者单位:210002南京,南京大学医学院附属金陵医院(东部战区总医院)骨科(袁涛、杨少强、赖圳登、钱洪、鱼鑫、江辉、孟嘉、包倪荣)
Author(s):
YUAN TaoYANG Shao-qiangLAI Cheng-TengQIAN Hong YU XinJIANG HuiMENG JiaBAO Ni-rong
(Department of Orthopedics, Jinling Hospital, School of Clinical Medicine, Nanjing University/General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu, China)
关键词:
肩袖损伤关节镜术“鸡尾酒”疗法罗哌卡因复方倍他米松
Keywords:
rotator cuff injury arthroscopic surgery cocktail injection therapy ropivacaine compound betamethasone
分类号:
R459.1
DOI:
10.3969/j.issn.1672-271X.2022.04.003
文献标志码:
A
摘要:
目的评估由罗哌卡因和复方倍他米松配制的“鸡尾酒”在肩袖损伤术后的镇痛效果,评价其安全有效性。方法对2019年3月至2020年6月期间在东部战区总医院行关节镜下肩袖损伤修补术的160例患者进行前瞻性双盲随机研究,所有患者按随机数字表法分为“鸡尾酒”疗法组和对照组,每组80例。“鸡尾酒”疗法组在术后向肩峰下间隙注射由罗哌卡因和复方倍他米松配制的“鸡尾酒”,对照组注射罗帕卡因。记录患者术前、术后6、12、24、48 h及术后1、2周患者VAS评分;对患者术前和术后2、4、12、24周Constant-Murley和UCLA评分进行评估分析,并通过术前和术后12周MRI检查观察肩袖修补术后愈合情况。结果“鸡尾酒”疗法组VAS评分在术后12 h至术后第2周明显低于对照组评分(P<0.05),在术后12 h后,VAS评分在“鸡尾酒”疗法组[(2.25±1.12)分]与对照组[(3.18±0.68)分]开始出现明显差异(P<0.05);术后第4周的Constant-Murley评分在对照组[(70.35±8.45)分]与“鸡尾酒”疗法组[(78.25±9.25)分]相比差异有统计学意义(P<0.05)、 UCLA评分在对照组[(20.65±6.10)分]与“鸡尾酒”疗法组[(28.95±6.78)分]相比差异有统计学意义(P<0.05),这些评分在术后3个月后差异无统计学意义(P>0.05);MRI检查提示2组患者肩袖在术后12周均愈合良好,无并发症发生。结论由罗哌卡因和复方倍他米松配制的“鸡尾酒”在肩袖损伤术后镇痛效果优良,可在术后早期明显改善患者肩关节疼痛及功能,从而在不增加术后并发症的同时有助于术后早期的康复。
Abstract:
ObjectiveTo evaluate the safety and effectiveness of "cocktail injection" prepared by ropivacaine and compound betamethasone in the postoperative analgesic of rotator cuff injury repair.MethodsA prospective double-blind randomized study was conducted on 160 patients who underwent arthroscopic supraspinatus rotator cuff injury repair in our department from March 2019 to June 2020. All patients were injected with cocktail injection in the subacromial space after arthroscopy surgery. Cocktail injection therapy included ropivacaine, the experimental group and the control group with or without compound betamethasone respectively. VAS scores were recorded before surgery, and 6 h, 12 h, 24 h, 48 h, 1 week, 2 weeks after surgery. Constant-Murley and UCLA scores were evaluated before surgery and at 2 weeks, 4 weeks, 3 months and 6 months after surgery, and the incidence of complications was observed.ResultsVAS score of the experimental group was lower than that of the control group during 12 hours to 2 weeks postoperatively (P<0.05). 12 h after surgery, VAS scores in the experimental group (2.25±1.12) began to show significant differences compared with the control group (3.18±0.68). Constant-Murley score of the control group (70.35±8.45) was significantly different from that of the experimental group (78.25±9.25) at week 4 after surgery (P<0.05). UCLA scores in the control group (20.65±6.10) were significantly different from those in the experimental group (28.95±6.78)(P<0.05), but there was no significant difference in these scores 3 months after surgery(P>0.05). MRI examination showed that the rotator cuff in both groups healed 12 weeks after surgery without complications.ConclusionThe "cocktail injection" therapy composed of ropivacaine and compound betamethasone has an excellent analgesic effect after rotator cuff injury repair, which does not increase postoperative complications and contributes to early postoperative recovery.

参考文献/References:

[1]Alrabaa RG, Lobao MH, Levine WN. Rotator Cuff Injuries in Tennis Players[J]. Curr Rev Musculoskelet Med, 2020,13(6):734-747.
[2]赖圳登, 包倪荣, 赵建宁. 肩袖损伤患者的夜间疼痛与生物钟的联系[J]. 医学研究生学报, 2019, 32(9): 999-1003.
[3]Milgrom C, Schaffler M, Gilbert S,et al. Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender[J]. J Bone Joint Surg Br, 1995,77(2):296-298.
[4]Nugent RE, Cheesman QT, Bradian AK,et al. Improvements in sexual function following arthroscopic rotator cuff repair[J]. J Shoulder Elbow Surg, 2021,30(3):652-657.
[5]DeFroda SF, Li L, Milner J,et al. Cost comparison of arthroscopic rotator cuff repair with arthroscopic vs. open biceps tenodesis[J]. J Shoulder Elbow Surg, 2021,30(2):340-345.
[6]徐鸿尧, 赵建宁, 包倪荣. 肩袖损伤的机制与修复方法的研究现状及进展[J]. 医学研究生学报, 2015, 28(2): 212-217.
[7]Rizvi SMT, Bishop M, Lam PH,et al. Factors Predicting Frequency and Severity of Postoperative Pain After Arthroscopic Rotator Cuff Repair Surgery[J]. Am J Sports Med, 2021,49(1):146-153.
[8]Patel MS, Abboud JA, Sethi PM. Perioperative pain management for shoulder surgery: evolving techniques[J]. J Shoulder Elbow Surg, 2020,29(11): e416-e433.
[9]Tian Y, Tang S, Sun S, et al. Comparison between local infiltration analgesia with combined femoral and sciatic nerve block for pain management after total knee arthroplasty[J]. J Orthop Surg Res, 2020,15(1):41.
[10]Kong DY, Oh JH, Choi WR,et al. The Impact of Epinephrine in the Periarticular Injection Cocktail using Ropivacaine for Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Comparison Study[J]. J Arthroplasty, 2020,35(9):2439-2443.
[11]Najfeld M, Hube R, Kujat AK, et al. Is changing the postoperative pain management in total knee arthroplasty from femoral nerve block to local infiltration analgesia successful? Retrospective trial with the first and last 100 patients[J]. J Orthop Surg Res, 2020,15(1):480.
[12]Bravin LN, Ernest EP, Dietz MJ, et al. Liposomal bupivacaine offers no benefit over ropivacaine for multimodal periarticular injection in total knee arthroplasty[J]. Orthopedics, 2020, 43(2): 91-96.
[13]Collis PN, Hunter AM, Vaughn MDD, et al. Periarticular injection after total knee arthroplasty using liposomal bupivacaine vs a modified Ranawat suspension: a prospective, randomized study[J]. J Arthroplasty, 2016, 31(3): 633-636.
[14]Hyland SJ, Deliberato DG, Fada RA, et al. Liposomal bupivacaine versus standard periarticular injection in total knee arthroplasty with regional anesthesia: a prospective randomized controlled trial[J]. J Arthroplasty, 2019, 34(3): 488-494.
[15]尹朱丹, 钟琦, 包倪荣, 等. 引起肩袖损伤术后再撕裂的非手术因素研究进展[J]. 东南国防医药, 2019, 21(6):631-635.
[16]Reddy UM. A study of cocktail injection: Pain control and knee motion recovery after total knee replacement[J]. Int J Orthopaed, 2021, 7(1): 616-619.
[17]Li Z, Li Z, Cheng K,et al. The Efficacy and Safety of Glucocorticoid on Periarticular Infiltration Analgesia in Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials[J]. J Arthroplasty, 2021, 36(9):3340-3350.
[18]Bravin LN, Ernest EP, Dietz MJ,et al. Liposomal Bupivacaine Offers No Benefit Over Ropivacaine for Multimodal Periarticular Injection in Total Knee Arthroplasty[J]. Orthopedics, 2020,43(2):91-96.
[19]Tuure L, Hmlinen M, Whittle BJ,et al. Microsomal Prostaglandin E Synthase-1 Expression in Inflammatory Conditions Is Downregulated by Dexamethasone: Seminal Role of the Regulatory Phosphatase MKP-1[J]. Front Pharmacol, 2017, 8:646.
[20]Chai X, Liu H, You C,et al. Efficacy of Additional Corticosteroid in a Multimodal Cocktail for Postoperative Analgesia Following Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials[J]. Pain Pract, 2019,19(3):316-327.
[21]Xiao LZ, Zou J, Fang Fk.Study of the therapeutic effects of betamethasone injection combined with musculoskeletal ultrasonography compared with radial shock wave therapy in the treatment of tenosynovitis of the long head of the biceps brachii[J].Am J Transl Res, 2021,13(3): 1734-1741.
[22]曹青刚, 赵建宁, 包倪荣. 肩袖修补术后关节内注射倍他米松联合罗哌卡因的临床疗效对比[J]. 医学研究生学报, 2018,31(12):1289-1292.

相似文献/References:

[1]尹朱丹,钟琦综述,包倪荣,等.引起肩袖损伤术后再撕裂的非手术因素研究进展[J].医学研究与战创伤救治(原医学研究生学报),2019,21(6):631.[doi:10.3969/j.issn.1672-271X.2019.06.017]
 YIN Zhu-dan,ZHONG Qi,reviewing,et al.Research progress on nonoperative factors leading to retear after rotator cuff repair[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2019,21(4):631.[doi:10.3969/j.issn.1672-271X.2019.06.017]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金(81772318);江苏省社会发展面上项目(BE2017723)
更新日期/Last Update: 2022-09-06