一项前瞻性随机对照研究:在帕瑞昔布基础上加用术前超声引导的肩胛上神经阻滞和腋神经阻滞,对关节镜下肩袖修复术后早期疼痛控制更有效。

{"title":"一项前瞻性随机对照研究:在帕瑞昔布基础上加用术前超声引导的肩胛上神经阻滞和腋神经阻滞,对关节镜下肩袖修复术后早期疼痛控制更有效。","authors":"","doi":"10.1016/j.arthro.2024.02.031","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div><span>To prospectively compare pain intensity and patient-reported outcomes (PROs) after arthroscopic rotator cuff repair (ARCR) between patients who received ultrasound-guided suprascapular nerve block (SSNB) and </span>axillary nerve<span> block (ANB) as well as preincisional parecoxib and patients who received preincisional parecoxib only.</span></div></div><div><h3>Methods</h3><div>Sixty-one patients receiving ARCR between March 2020 and March 2021 were prospectively enrolled. They were randomly assigned to the peripheral nerve block<span> group (group N, n = 30) or control group (group C, n = 31). Two patients in group C were excluded because of miscommunication. All patients were administered 40 mg of parecoxib intravenously prior to induction of anesthesia<span><span>. SSNB and ANB were performed after general anesthesia in group N, whereas no nerve block was performed in group C. Pain intensity was compared before surgery, as well as immediately, 24 hours, and 2 weeks after surgery. PROs, including the </span>Oxford Shoulder Score, University of California–Los Angeles shoulder score, and Single Assessment Numeric Evaluation score, were compared before and 6 months after surgery.</span></span></div></div><div><h3>Results</h3><div><span>The numerical rating scale (NRS) score for resting pain was significantly lower in group N (4.9 ± 3.1 vs 7.6 ± 2.5, </span><em>P</em> &lt; .001) immediately after surgery, but no difference was noted 24 hours after surgery. The resting pain NRS score 2 weeks after surgery was significantly lower in group N (1.4 ± 1.6 vs 2.7 ± 2.7, <em>P</em> = .03), but the scores for movement-evoked pain and night pain were similar. All PROs significantly improved 6 months after surgery in both groups, but there was no difference between the 2 groups.</div></div><div><h3>Conclusions</h3><div>The addition of preoperative ultrasound-guided SSNB and ANB to parecoxib offered better resting pain control immediately and 2 weeks after ARCR, but there was no benefit for PROs 6 months after surgery.</div></div><div><h3>Level of Evidence</h3><div>Level II, prospective randomized controlled trial.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"40 10","pages":"Pages 2532-2539"},"PeriodicalIF":4.4000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Addition of Preoperative Ultrasound-Guided Suprascapular Nerve Block and Axillary Nerve Block to Parecoxib Is More Effective in Early Postoperative Pain Control After Arthroscopic Rotator Cuff Repair: A Prospective Randomized Controlled Study\",\"authors\":\"\",\"doi\":\"10.1016/j.arthro.2024.02.031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div><span>To prospectively compare pain intensity and patient-reported outcomes (PROs) after arthroscopic rotator cuff repair (ARCR) between patients who received ultrasound-guided suprascapular nerve block (SSNB) and </span>axillary nerve<span> block (ANB) as well as preincisional parecoxib and patients who received preincisional parecoxib only.</span></div></div><div><h3>Methods</h3><div>Sixty-one patients receiving ARCR between March 2020 and March 2021 were prospectively enrolled. They were randomly assigned to the peripheral nerve block<span> group (group N, n = 30) or control group (group C, n = 31). Two patients in group C were excluded because of miscommunication. All patients were administered 40 mg of parecoxib intravenously prior to induction of anesthesia<span><span>. SSNB and ANB were performed after general anesthesia in group N, whereas no nerve block was performed in group C. Pain intensity was compared before surgery, as well as immediately, 24 hours, and 2 weeks after surgery. PROs, including the </span>Oxford Shoulder Score, University of California–Los Angeles shoulder score, and Single Assessment Numeric Evaluation score, were compared before and 6 months after surgery.</span></span></div></div><div><h3>Results</h3><div><span>The numerical rating scale (NRS) score for resting pain was significantly lower in group N (4.9 ± 3.1 vs 7.6 ± 2.5, </span><em>P</em> &lt; .001) immediately after surgery, but no difference was noted 24 hours after surgery. The resting pain NRS score 2 weeks after surgery was significantly lower in group N (1.4 ± 1.6 vs 2.7 ± 2.7, <em>P</em> = .03), but the scores for movement-evoked pain and night pain were similar. All PROs significantly improved 6 months after surgery in both groups, but there was no difference between the 2 groups.</div></div><div><h3>Conclusions</h3><div>The addition of preoperative ultrasound-guided SSNB and ANB to parecoxib offered better resting pain control immediately and 2 weeks after ARCR, but there was no benefit for PROs 6 months after surgery.</div></div><div><h3>Level of Evidence</h3><div>Level II, prospective randomized controlled trial.</div></div>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":\"40 10\",\"pages\":\"Pages 2532-2539\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2024-10-01\",\"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://www.sciencedirect.com/science/article/pii/S074980632400166X\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S074980632400166X","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

摘要

目的:该研究旨在前瞻性地比较接受超声引导下肩胛上神经阻滞(SSNB)和腋神经阻滞(ANB)以及手术前帕瑞昔布治疗的患者与仅接受手术前帕瑞昔布治疗的患者在关节镜下肩袖修复术(ARCR)后的疼痛强度和患者报告结果(PROs):在 2020 年 3 月至 2021 年 3 月期间接受 ARCR 的 61 名患者被纳入前瞻性研究。他们被随机分配到周围神经阻滞组(N 组,n=30)或对照组(C 组,n=31)。由于沟通不畅,C 组的两名患者被排除在外。所有患者在麻醉诱导前均静脉注射帕瑞昔布 40 毫克。N 组在全身麻醉后进行 SSNB/ANB,而 C 组未进行神经阻滞。术前、术中、术后 24 小时和 2 周的疼痛强度进行了比较。比较了手术前和手术后6个月的PROs,包括牛津肩关节评分、加州大学洛杉矶分校肩关节评分和单一评估数字评价评分:结果:N组患者的静息疼痛数字评定量表(NRS)明显降低(4.9 ± 3.1 vs. 7.6 ± 2.5,p):在帕瑞昔布的基础上加用术前超声引导的SSNB和ANB,可在ARCR术后即刻和2周内更好地控制静息痛,但术后6个月对PROs没有益处:2级前瞻性随机对照试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Addition of Preoperative Ultrasound-Guided Suprascapular Nerve Block and Axillary Nerve Block to Parecoxib Is More Effective in Early Postoperative Pain Control After Arthroscopic Rotator Cuff Repair: A Prospective Randomized Controlled Study

Purpose

To prospectively compare pain intensity and patient-reported outcomes (PROs) after arthroscopic rotator cuff repair (ARCR) between patients who received ultrasound-guided suprascapular nerve block (SSNB) and axillary nerve block (ANB) as well as preincisional parecoxib and patients who received preincisional parecoxib only.

Methods

Sixty-one patients receiving ARCR between March 2020 and March 2021 were prospectively enrolled. They were randomly assigned to the peripheral nerve block group (group N, n = 30) or control group (group C, n = 31). Two patients in group C were excluded because of miscommunication. All patients were administered 40 mg of parecoxib intravenously prior to induction of anesthesia. SSNB and ANB were performed after general anesthesia in group N, whereas no nerve block was performed in group C. Pain intensity was compared before surgery, as well as immediately, 24 hours, and 2 weeks after surgery. PROs, including the Oxford Shoulder Score, University of California–Los Angeles shoulder score, and Single Assessment Numeric Evaluation score, were compared before and 6 months after surgery.

Results

The numerical rating scale (NRS) score for resting pain was significantly lower in group N (4.9 ± 3.1 vs 7.6 ± 2.5, P < .001) immediately after surgery, but no difference was noted 24 hours after surgery. The resting pain NRS score 2 weeks after surgery was significantly lower in group N (1.4 ± 1.6 vs 2.7 ± 2.7, P = .03), but the scores for movement-evoked pain and night pain were similar. All PROs significantly improved 6 months after surgery in both groups, but there was no difference between the 2 groups.

Conclusions

The addition of preoperative ultrasound-guided SSNB and ANB to parecoxib offered better resting pain control immediately and 2 weeks after ARCR, but there was no benefit for PROs 6 months after surgery.

Level of Evidence

Level II, prospective randomized controlled trial.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
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.
期刊最新文献
Letter Regarding "Adding Dexmedetomidine to Intra-Articular Local Anesthetics Results in Prolonged Analgesia After Knee Arthroscopy: A Systematic Review and Meta-analysis" - Authors' Reply. Most Athletes who fail to Return to Sport After Latarjet Procedure Cite Psychological Factors: a Systematic Review. Author Reply to Letter to the Editor "Comments on the Article 'Anterior Opening-Wedge High Tibial Osteotomy in the Setting of Genu Recurvatum'". Comments on the article "Technical Note: Anterior opening-wedge high tibial osteotomy in the setting of genu recurvatum" published in Arthroscopy Techniques 2023, 12(11): e1559 - e1566. Editorial Commentary: Anatomic Tibiofibular and Partially Anatomic-Based Fibular Posterolateral Corner Reconstruction Techniques Are Biomechanically Superior to Non-Anatomic Reconstruction Techniques: A Tibial Tunnel is the Gold Standard for An Anatomic Reconstruction.
×
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
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 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 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1