Preoperative versus postoperative nonsteroidal anti-inflammatory drugs in femoroacetabular impingement patients undergoing hip arthroscopy surgery: analgesic effect, joint function, patients' satisfaction, and quality of life.

IF 4.6 2区医学 Q2 IMMUNOLOGY Inflammopharmacology Pub Date : 2024-12-01 Epub Date: 2024-08-10 DOI:10.1007/s10787-024-01540-w

Zhiyuan Guo, Guangfei Liu, Weibin Li, Shouliang Lu, Ye Zhao, Lu Wang, Cai Cheng

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Abstract

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) have analgesic effects on femoroacetabular impingement (FAI) patients undergoing hip arthroscopy surgery (HAS). However, the influence of medication time on the analgesic effect of NSAIDs is uncertain. This study aimed to compare the analgesic effect, joint function, quality of life (QoL), and patients' satisfaction between preoperative and postoperative NSAIDs in these patients.

Methods: In this prospective, observational study, 165 FAI patients undergoing HAS with NSAIDs (celecoxib, meloxicam, and nimesulide) for analgesia were divided into preoperative (PRE-A) and postoperative analgesia (POST-A) groups according to their actual medication.

Results: The visual analog scale (VAS) pain scores on the 1st (P < 0.001) and 3rd (D3) (P = 0.015) days after the operation were lower in the PRE-A group versus the POST-A group but not preoperatively (P = 0.262) or on the 7th day after the operation (D7) (P = 0.302). The proportion of patients receiving rescue analgesia decreased in the PRE-A group versus POST-A group (P = 0.041). However, the modified Harris hip score (mHHS), proportion of patients with an mHHS ≥ 70, and EuroQol-5-dimensional score at preoperative, 1st month (M1), and 3rd month (M3) after the operation were similar between the groups (all P > 0.050). The VAS score on D7 was greater in the PRE-A group compared to the POST-A group (P = 0.014), but the scores at M1 and M3 and the satisfaction and very satisfaction rates at D7, M1, and M3 did not differ between the groups (all P > 0.050). Subgroup analysis revealed that the type of NSAID did not affect most outcomes.

Conclusion: Preoperative NSAIDs elevate analgesic effect and patients' satisfaction, but not joint function or QoL compared to postoperative NSAIDs in FAI patients undergoing HAS.

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接受髋关节镜手术的股骨髋臼撞击症患者术前与术后使用非甾体抗炎药的对比：镇痛效果、关节功能、患者满意度和生活质量。

背景：非甾体抗炎药（NSAIDs）对接受髋关节镜手术（HAS）的股骨面撞击症（FAI）患者有镇痛作用。然而，用药时间对非甾体抗炎药镇痛效果的影响尚不确定。本研究旨在比较这些患者术前和术后服用非甾体抗炎药的镇痛效果、关节功能、生活质量（QoL）和患者满意度：在这项前瞻性观察研究中，165名接受HAS手术并使用非甾体抗炎药（塞来昔布、美洛昔康和尼美舒利）镇痛的FAI患者根据实际用药情况被分为术前镇痛组（PRE-A）和术后镇痛组（POST-A）：第1天的视觉模拟量表（VAS）疼痛评分（P 0.050）。与 POST-A 组相比，PRE-A 组 D7 日的 VAS 评分更高（P = 0.014），但 M1 和 M3 日的评分以及 D7、M1 和 M3 日的满意率和非常满意率在各组之间没有差异（均 P > 0.050）。亚组分析显示，非甾体抗炎药的类型对大多数结果没有影响：结论：与术后服用非甾体抗炎药相比，术前服用非甾体抗炎药可提高FAI患者的镇痛效果和患者满意度，但不能提高关节功能或QoL。

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]