The effect of intravenous vitamin C administration on postoperative pain and intraoperative blood loss in older patients after intramedullary nailing of trochanteric fractures.
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引用次数: 0
Abstract
Purpose: The purpose of this study was to determine the effects of peri and postoperative intravenous vitamin C administration on severity of postoperative pain and intraoperative blood loss in patients with trochanteric fracture treated with intramedullary nailing.
Methods: A prospective, single-blinded, controlled, randomised clinical study was conducted. It included 60 patients who were randomly divided into the Vitamin C and Control groups. Baseline characteristics, haemoglobin levels, number of Red Blood Cell (RBC) units transfusion, and metamizole consumption were noted in each group. Visual Analogue Scale (VAS) score was evaluated at 24 and 48 h postoperatively.
Results: There were no differences between the groups concerning age, gender, length of hospitalisation, fracture type distribution, preoperative and postoperative haemoglobin levels. Postoperative metamizole consumption was higher in the Control group than in the Vitamin C group, with statistically significant difference (p = 0.003). The median VAS scores were higher in the Control group compared to the Vitamin C group at 24 and 48 h postoperatively with significant differences (p = 0.001 and p < 0.0005, respectively). Multivariate logistic regression analysis revealed two independent predictors of postoperative blood transfusion: unstable fracture pattern (OR = 0.065, 95% CI 0.007-0.571, p = 0.014), and preoperative haemoglobin level (OR = 903, 95% CI 0.846-0.965, p = 0.003).
Conclusion: The results showed significant reduction of subjective pain levels and lower analgesic consumption in patients who received intravenous vitamin C, suggesting that it could be considered as an adjuvant agent for analgesia in older patients with hip fracture. Unstable fracture pattern and preoperative haemoglobin levels significantly contributed to postoperative blood transfusion requirement.
目的：本研究旨在确定髓内钉治疗转子骨骨折患者术前和术后静脉注射维生素 C 对术后疼痛严重程度和术中失血量的影响：进行了一项前瞻性、单盲、对照、随机临床研究。该研究包括 60 名患者，他们被随机分为维生素 C 组和对照组。每组患者的基线特征、血红蛋白水平、输注红细胞（RBC）单位数和甲硝唑用量均有记录。术后 24 小时和 48 小时对视觉模拟量表（VAS）进行评分：结果：各组在年龄、性别、住院时间、骨折类型分布、术前和术后血红蛋白水平等方面均无差异。对照组术后甲氰咪胍用量高于维生素 C 组，差异有统计学意义（P = 0.003）。与维生素 C 组相比，对照组术后 24 小时和 48 小时的 VAS 评分中位数更高，差异显著（p = 0.001 和 p 结论：维生素 C 组术后 24 小时和 48 小时的 VAS 评分中位数更高，差异显著（p = 0.001）：结果显示，静脉注射维生素 C 的患者主观疼痛程度明显减轻，镇痛剂用量减少，这表明维生素 C 可被视为老年髋部骨折患者镇痛的辅助药物。不稳定的骨折模式和术前血红蛋白水平是导致术后输血需求的重要原因。
期刊介绍：
European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine.
The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.
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