连续导管内收管阻滞对膝关节置换术疼痛管理的影响:一项荟萃分析。

IF 4.1 Q1 ORTHOPEDICS Knee Surgery & Related Research Pub Date : 2023-06-01 DOI:10.1186/s43019-023-00188-0
Aiden Jabur, Hyun Jae Nam, Asher Dixon, Tynan Cox, Hayden Randall, Jing Sun
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引用次数: 0

摘要

目的:内收管阻滞已成为全膝关节置换术中多模式镇痛方案的一个有利因素,因为它提供了排他性的感觉阻滞。然而,对于单针内收管阻滞术和连续内收管阻滞术孰优孰优,存在争议。本荟萃分析检查了这两种技术对全膝关节置换术相关疼痛管理的影响。方法:系统检索Cochrane Library、PubMed、EMBASE、Scopus和PsychINFO上发表的所有随机对照试验。采用PEDro量表评估研究质量。共有8篇文章,其中2篇通过亚组分析分为10项研究,其中828名成年人被选择纳入分析。分析合并结果的平均差异和95%置信区间(CI)的效应大小。结果:在降低疼痛评分和VAS评分以及总镇痛剂量方面,镇痛技术有利于导管使用的综合效应具有统计学意义。住院时间未见明显变化。亚组分析显示,BMI为30或更高的患者报告的疼痛评分高于BMI为30以下的患者。结论:基于现有的研究,我们的荟萃分析似乎表明,在全膝关节置换术中,通过内收肌管导管持续给药镇痛比单次镇痛更能减轻疼痛。尽管有这些目前的发现,未来的研究需要更大的样本量和更大的研究参数控制来证实目前的发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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The effects of continuous catheter adductor canal block for pain management in knee replacement therapy: a meta-analysis.

Purpose: Adductor canal block has emerged as a favourable element of multimodal analgesia regimens for total knee arthroplasty, due to the exclusive sensory blockade it provides. However, it is controversial as to whether a single shot or continuous technique adductor canal block is superior. This meta-analysis examined the effect of both these techniques on pain management associated with total knee arthroplasty.

Methods: All randomised controlled trials published on Cochrane Library, PubMed, and EMBASE, Scopus, and PsychINFO were systematically searched. The PEDro scale was used to assess the quality of studies. A total of 8 articles, 2 of which were split by subgroup analyses to create 10 studies, with 828 adults were selected for inclusion in the analysis. The mean difference and effect size with a 95% confidence interval (CI) were analysed for the pooled results.

Results: Statistically significant pooled effects of analgesia technique in favour of catheter use were found in the reduction of pain scores and VAS scores, and total rescue analgesia dosage. No significant changes were observed in the hospital stay time. Subgroup analysis revealed that patients with BMI 30 or more reported higher pain scores than those with BMI below 30.

Conclusion: Based upon studies that are currently available, our meta-analysis appears to demonstrate that continuous administration of analgesia through an adductor canal catheter provides greater pain reduction in total knee arthroplasty than single shot analgesia. Despite these current findings, future studies with larger sample sizes and greater control of study parameters are required to confirm the current findings.

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