Abstract：
Total knee arthroplasty (TKA) is a routine orthopedic procedure often associated with significant postoperative pain. Efficient pain management is paramount for patient recovery, with nonsteroidal anti-inflammatory drugs (NSAIDs) being a common choice. Nevertheless, the specific NSAID and its dosing regimen can have varying impacts on outcomes.
In this retrospective cohort study spanning from January 2016 to December 2020, we analyzed patients who underwent TKA. These patients were divided into two groups: one receiving preemptive low-dose ketorolac (15 mg) followed by 15 mg every 6 h for 48 h, and the other receiving parecoxib (40 mg) every 12 h for the same duration. We assessed pain scores, opioid consumption, and monitored adverse events.
Our findings reveal that ketorolac yielded superior results compared to parecoxib. Specifically, patients receiving ketorolac reported significantly lower Visual Numeric Rating Scale (VNRS) scores at 8- and 20-h post-surgery. This trend was further confirmed by linear mixed models (p = .0084). Additionally, ketorolac was associated with reduced opioid consumption during the initial 24 h. Importantly, the rates of adverse events were comparable between the two groups.
The utilization of preemptive low-dose ketorolac demonstrates promising potential in bolstering pain control within the initial 24 h post-TKA, potentially reducing the need for opioids. However, further exploration is required to thoroughly assess its prolonged analgesic effects and safety across various surgical contexts. These investigations could provide invaluable insights for optimizing pain management protocols.
In this retrospective cohort study spanning from January 2016 to December 2020, we analyzed patients who underwent TKA. These patients were divided into two groups: one receiving preemptive low-dose ketorolac (15 mg) followed by 15 mg every 6 h for 48 h, and the other receiving parecoxib (40 mg) every 12 h for the same duration. We assessed pain scores, opioid consumption, and monitored adverse events.
Our findings reveal that ketorolac yielded superior results compared to parecoxib. Specifically, patients receiving ketorolac reported significantly lower Visual Numeric Rating Scale (VNRS) scores at 8- and 20-h post-surgery. This trend was further confirmed by linear mixed models (p = .0084). Additionally, ketorolac was associated with reduced opioid consumption during the initial 24 h. Importantly, the rates of adverse events were comparable between the two groups.
The utilization of preemptive low-dose ketorolac demonstrates promising potential in bolstering pain control within the initial 24 h post-TKA, potentially reducing the need for opioids. However, further exploration is required to thoroughly assess its prolonged analgesic effects and safety across various surgical contexts. These investigations could provide invaluable insights for optimizing pain management protocols.
摘要：
背景：全膝关节置换术（TKA）是一种常规的骨科手术，通常伴有明显的术后疼痛。有效的疼痛管理对于患者的康复至关重要，非甾体抗炎药（NSAIDs）是常见的选择。然而，具体的NSAID及其给药方案可能对结局产生不同的影响.
方法：在2016年1月至2020年12月的这项回顾性队列研究中，我们分析了接受TKA的患者。这些患者分为两组：一组接受先发制人的低剂量酮咯酸（15毫克），然后每6小时15毫克，持续48小时。另一个人每12小时接受帕瑞昔布（40毫克），持续时间相同。我们评估了疼痛评分，阿片类药物的消费，并监测不良事件。
结果：我们的研究结果表明，酮咯酸与帕瑞昔布相比产生了更好的结果。具体来说,接受酮咯酸治疗的患者在术后8小时和20小时报告视觉数字评定量表(VNRS)评分显著较低.线性混合模型(p=.0084)进一步证实了这一趋势。此外,酮咯酸与最初24小时内阿片类药物消耗减少有关。重要的是，两组的不良事件发生率相当.
结论：先发制人的低剂量酮咯酸的使用显示出在TKA后最初24小时内支持疼痛控制的有希望的潜力，有可能减少对阿片类药物的需求。然而,需要进一步探索,以全面评估其在各种手术环境中的长期镇痛效果和安全性.这些研究可以为优化疼痛管理方案提供宝贵的见解。
方法：在2016年1月至2020年12月的这项回顾性队列研究中，我们分析了接受TKA的患者。这些患者分为两组：一组接受先发制人的低剂量酮咯酸（15毫克），然后每6小时15毫克，持续48小时。另一个人每12小时接受帕瑞昔布（40毫克），持续时间相同。我们评估了疼痛评分，阿片类药物的消费，并监测不良事件。
结果：我们的研究结果表明，酮咯酸与帕瑞昔布相比产生了更好的结果。具体来说,接受酮咯酸治疗的患者在术后8小时和20小时报告视觉数字评定量表(VNRS)评分显著较低.线性混合模型(p=.0084)进一步证实了这一趋势。此外,酮咯酸与最初24小时内阿片类药物消耗减少有关。重要的是，两组的不良事件发生率相当.
结论：先发制人的低剂量酮咯酸的使用显示出在TKA后最初24小时内支持疼痛控制的有希望的潜力，有可能减少对阿片类药物的需求。然而,需要进一步探索,以全面评估其在各种手术环境中的长期镇痛效果和安全性.这些研究可以为优化疼痛管理方案提供宝贵的见解。
