全膝关节置换术后减轻("轻")压迫与短暂包扎以控制术后疼痛的评估;单中心随机对照试验

Matt Dawson , William Hage , Cristian Nita , Lucy Bell , Janice Gorman , Leon Jonker
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引用次数: 0

摘要

目的研究减压绷带在控制全膝关节置换术后疼痛方面的疗效。患者与样本;方法前瞻性、单中心、随机对照试验,涉及 94 名同意患者中 56 名的数据;29 名标准护理与 27 名 Andoflex TLC Calamine Lite。比较标准护理(最多使用一天的非压力绷带)与使用五天的 Andoflex TLC Calamine Lite(25-30 mmHg)双层压力绷带。结果术后第 5 天,中位疼痛水平分别为 3.0 厘米和 4.0 厘米(P 值为 0.47,Mann-Whitney U 检验)。在术后第 3/5/12 天和第 6 周,干预措施之间的一般疼痛程度、疼痛类型和膝关节功能没有差异。但在第 12 天,"触痛 "程度在 Andoflex TLC Calamine Lite 治疗组明显降低(P 值 0.041,Mann-Whitney U 检验)。二元逻辑回归分析表明,使用 Andoflex TLC Calamine Lite、服用羟考酮、男性性别都与 "压痛 "程度较轻有明显关系。在评估控制疼痛的辅助疗法时,患者对阿片类药物(羟考酮)的需求和使用是一个重要的混杂变量。因此,减压绷带的适用性可能有限,而且不如药物止痛有效。
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Evaluation of reduced (‘Lite’) compression versus brief bandaging to manage post-operative pain after total knee arthroplasty surgery; a single-centre randomised controlled trial

Purpose

Investigate efficacy of reduced compression bandage for the control of pain after total knee arthroplasty.

Patients & methods

Prospective, single-centre, randomised controlled trial involving data for 56 out of 94 consented patients; 29 standard care versus 27 Andoflex TLC Calamine Lite. Comparison of standard care (non-compression bandage applied for up to one day) versus Andoflex TLC Calamine Lite (25–30 mmHg) two-layer compression bandage worn for five days. Outcomes measured with validated pain (McGill, 10-cm visual scale) and functionality (KOOS) tools.

Results

At day 5 post-surgery, the median pain level was 3.0 cm vs 4.0 cm (p-value 0.47, Mann-Whitney U test) respectively. Generic pain levels, pain types, and knee functionality did not differ between the interventions at days 3/5/12 and week 6 post-surgery. An exception was the degree of ‘tender’ pain at day 12, which was significantly lower in the Andoflex TLC Calamine Lite arm (p-value 0.041, Mann-Whitney U test). Binary logistic regression analysis showed that application of Andoflex TLC Calamine Lite, administration of oxycodone, and male sex were all significantly associated with less ‘tender’ pain.

Conclusion

Reduced compression bandaging does not affect overall pain levels post knee arthroplasty surgery, but may alleviate pain experienced as ‘tender’, highlighting the different types of pain that may be experienced. Patients' need for, and the use of, opioid medication (oxycodone) is a significant confounding variable when assessing adjuvant therapy to control pain. The applicability of reduced compression bandaging may therefore be limited and is less efficient than medical pain control.

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来源期刊
CiteScore
2.60
自引率
14.30%
发文量
34
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