Intravenous Carbazochrome Sodium Sulfonate Improves Visual Clarity in Patients Undergoing Arthroscopic Rotator Cuff Repair: A Randomised Controlled, Triple-Blinded, Prospective Study.

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Lihan Shi, Yong Huang, Pai Zheng, Jiayuan Peng, Fuchuan Ren, Guangwei Che
{"title":"Intravenous Carbazochrome Sodium Sulfonate Improves Visual Clarity in Patients Undergoing Arthroscopic Rotator Cuff Repair: A Randomised Controlled, Triple-Blinded, Prospective Study.","authors":"Lihan Shi, Yong Huang, Pai Zheng, Jiayuan Peng, Fuchuan Ren, Guangwei Che","doi":"10.1016/j.arthro.2025.01.051","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical efficacy of intravenous carbazochrome sodium sulfonate (CSS), an oxidation substance of epinephrine, in improving visual clarity (VC), perioperative hemostasis, and anti-inflammatory effects during arthroscopic rotator cuff repair.</p><p><strong>Methods: </strong>This was a single-center, single-surgeon, randomized, controlled, triple-blinded, prospective study. Between August 2023 and August 2024, 195 patients undergoing arthroscopic rotator cuff repair were enrolled and randomly assigned to 1 of 3 groups: Group A received an intravenous infusion of CSS; group B received an intravenous infusion of tranexamic acid; and group C received an intravenous infusion of 0.9% sodium chloride. Patients with massive rotator cuff tear, frozen shoulder, hypertension, severe liver or renal dysfunction, long-term use of anticoagulants or antiplatelet drugs, bleeding disorders, or severe cardiopulmonary diseases were excluded. After each surgical procedure, a trained and independent evaluator assessed the clarity of images based on the VC scale, and all related clinical outcomes were recorded. The primary outcome was arthroscopic VC. The secondary outcomes were operative duration, irrigation fluid volume, red blood cell count of discarded irrigation fluid samples, intraoperative mean blood pressure, inflammatory marker levels, hemoglobin levels, visual analog scale (VAS) pain score, and shoulder joint enlargement rate.</p><p><strong>Results: </strong>In total, 195 patients were enrolled, and they were randomized into 1 of 3 groups: Group A comprised 65 patients (21 men and 44 women) with a mean age of 56.4 years; group B, 65 patients (29 men and 36 women) with a mean age of 57.0 years; and group C, 65 patients (24 men and 41 women) with a mean age of 56.7 years. VC scale scores were not significantly different during arthroscopic examination (5 [range, 4 to 5] in group A vs 5 [range, 4 to 5] in group B vs 5 [range, 4 to 5] in group C; P = .859), but group A had higher scores than groups B and C during subacromial treatment (5 [range, 5 to 5] vs 4 [range, 3 to 4] vs 3 [range, 2 to 3.5]; P < .001) and rotator cuff repair (5 [range, 5 to 5] vs 4 [range, 3 to 4] vs 3 [range, 3 to 4]; P < .001). Group A showed significant advantages over groups B and C in operative duration (50.4 ± 8.0 minutes vs 66.4 ± 13.7 minutes vs 70.2 ± 17.4 minutes; P < .001), intraoperative infusion volume (11,338.5 ± 1,381.0 mL vs 18,483.1 ± 1,808.7 mL vs 19,047.7 ± 1,984.1 mL; P < .001), postoperative shoulder joint enlargement rate (8.2% [range, 3.0% to 11.7%] vs 14.1% [range, 9.2% to 18.1%] vs 15.4% [range, 13.8% to 16.3%]; P < .001), and red blood cell count of discarded infusion samples (12.6 ± 2.3 × 10<sup>9</sup>/L vs 19.6 ± 2.0 × 10<sup>9</sup>/L vs 20.4 ± 2.2 × 10<sup>9</sup>/L; P < .001). On postoperative days (PODs) 1, 2, and 3, hemoglobin levels were significantly lower in group C than in groups A and B. Inflammatory marker levels on PODs 1, 2, and 3 were not significantly different between groups A and B (P > .05) but were significantly lower in groups A and B than in group C (P < .05). A total of 157 patients (80.51% of the overall cohort) showed a change in the VAS pain score that met the MCID threshold 3 days after surgery. VAS scores on PODs 1, 2, and 3 were lower in group A than in groups B and C (P < .05). No adverse drug reactions or surgical complications occurred in any patients.</p><p><strong>Conclusions: </strong>CSS can effectively improve VC, reduce perioperative blood loss, decrease the inflammatory response, and alleviate early postoperative pain and shoulder joint swelling, and it does not increase the incidence of adverse reactions and complications.</p><p><strong>Level of evidence: </strong>Level I, randomized clinical trial.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":4.4000,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2025.01.051","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: To investigate the clinical efficacy of intravenous carbazochrome sodium sulfonate (CSS), an oxidation substance of epinephrine, in improving visual clarity (VC), perioperative hemostasis, and anti-inflammatory effects during arthroscopic rotator cuff repair.

Methods: This was a single-center, single-surgeon, randomized, controlled, triple-blinded, prospective study. Between August 2023 and August 2024, 195 patients undergoing arthroscopic rotator cuff repair were enrolled and randomly assigned to 1 of 3 groups: Group A received an intravenous infusion of CSS; group B received an intravenous infusion of tranexamic acid; and group C received an intravenous infusion of 0.9% sodium chloride. Patients with massive rotator cuff tear, frozen shoulder, hypertension, severe liver or renal dysfunction, long-term use of anticoagulants or antiplatelet drugs, bleeding disorders, or severe cardiopulmonary diseases were excluded. After each surgical procedure, a trained and independent evaluator assessed the clarity of images based on the VC scale, and all related clinical outcomes were recorded. The primary outcome was arthroscopic VC. The secondary outcomes were operative duration, irrigation fluid volume, red blood cell count of discarded irrigation fluid samples, intraoperative mean blood pressure, inflammatory marker levels, hemoglobin levels, visual analog scale (VAS) pain score, and shoulder joint enlargement rate.

Results: In total, 195 patients were enrolled, and they were randomized into 1 of 3 groups: Group A comprised 65 patients (21 men and 44 women) with a mean age of 56.4 years; group B, 65 patients (29 men and 36 women) with a mean age of 57.0 years; and group C, 65 patients (24 men and 41 women) with a mean age of 56.7 years. VC scale scores were not significantly different during arthroscopic examination (5 [range, 4 to 5] in group A vs 5 [range, 4 to 5] in group B vs 5 [range, 4 to 5] in group C; P = .859), but group A had higher scores than groups B and C during subacromial treatment (5 [range, 5 to 5] vs 4 [range, 3 to 4] vs 3 [range, 2 to 3.5]; P < .001) and rotator cuff repair (5 [range, 5 to 5] vs 4 [range, 3 to 4] vs 3 [range, 3 to 4]; P < .001). Group A showed significant advantages over groups B and C in operative duration (50.4 ± 8.0 minutes vs 66.4 ± 13.7 minutes vs 70.2 ± 17.4 minutes; P < .001), intraoperative infusion volume (11,338.5 ± 1,381.0 mL vs 18,483.1 ± 1,808.7 mL vs 19,047.7 ± 1,984.1 mL; P < .001), postoperative shoulder joint enlargement rate (8.2% [range, 3.0% to 11.7%] vs 14.1% [range, 9.2% to 18.1%] vs 15.4% [range, 13.8% to 16.3%]; P < .001), and red blood cell count of discarded infusion samples (12.6 ± 2.3 × 109/L vs 19.6 ± 2.0 × 109/L vs 20.4 ± 2.2 × 109/L; P < .001). On postoperative days (PODs) 1, 2, and 3, hemoglobin levels were significantly lower in group C than in groups A and B. Inflammatory marker levels on PODs 1, 2, and 3 were not significantly different between groups A and B (P > .05) but were significantly lower in groups A and B than in group C (P < .05). A total of 157 patients (80.51% of the overall cohort) showed a change in the VAS pain score that met the MCID threshold 3 days after surgery. VAS scores on PODs 1, 2, and 3 were lower in group A than in groups B and C (P < .05). No adverse drug reactions or surgical complications occurred in any patients.

Conclusions: CSS can effectively improve VC, reduce perioperative blood loss, decrease the inflammatory response, and alleviate early postoperative pain and shoulder joint swelling, and it does not increase the incidence of adverse reactions and complications.

Level of evidence: Level I, randomized clinical trial.

求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信