因晚期骨关节炎接受全膝关节置换术的患者在术后第一年的镇痛剂使用量可能不会减少

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2024-11-07 DOI:10.1016/j.jcot.2024.102800

Ahmet Aslan , Erkan Maytalman , Anil Gulcu

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引用次数: 0

摘要

背景全膝关节置换术（TKA）有望减轻晚期膝关节骨性关节炎患者的疼痛并减少止痛药的使用。然而，在某些情况下，患者的疼痛并未得到缓解，镇痛剂的使用仍在继续。本研究的目的是比较同一患者组在 TKA 手术前后一年的镇痛剂用量，并评估 TKA 手术后镇痛剂用量是否会减少。计算手术前后一年内所有镇痛药的用量，并将其转换为口服吗啡当量（OME）。评估中使用了患者的人口统计学数据、累积口服吗啡当量以及西安大略和麦克马斯特大学骨关节炎指数（WOMAC）的评分。虽然镇痛剂的平均用量比治疗前有所减少，但没有统计学意义。此外，年龄和术前镇痛药使用量是影响术后镇痛药总用量的两个最重要因素。此外，年龄和术前镇痛药的使用被认为是影响术后镇痛药消耗量的两个主要因素。

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Analgesic use may not decrease in the first postoperative year in patients underwent total knee arthroplasty due to advanced osteoarthritis

Background

Total knee arthroplasty (TKA) is expected to relieve pain and reduce the use of analgesics in patients with advanced knee osteoarthritis. However, in some cases, there is no relief in the pain of the patients and the use of analgesics continues. The aim of this study was to compare analgesic consumption one year before and after TKA in the same patient group and to evaluate whether there is a decrease in analgesic consumption after TKA.

Method

The cumulative amounts of analgesia used by the patients in the one-year periods before and after the operation were checked from the automated patient records system and the national systems showing drug prescriptions. The dosages of all the analgesics used in the one-year periods before and after the operation were calculated and converted to oral morphine equivalents (OME). The demographic data of the patients, cumulative OME and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used in the assessment.

Results

It was observed that there was a statistically significant improvement in Womac scores after the treatment compared to the pre-treatment. Although the mean amount of analgesics decreased compared to pre-treatment, it was not statistically significant. Also, age and preoperative analgesic use were found to be the two most important factors in relation to total postoperative analgesic consumption.

Conclusion

The results of this study indicate that there may not be a substantial reduction in the use of analgesic by patients within the first year after TKA. Furthermore, the age and preoperative analgesic use were identified as the two primary factors influencing postoperative analgesic consumption.

Level of evidence

Retrospective Cohort Study.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.