Abstract：
OBJECTIVE: Little is known about the optimal analgesia regimen after HTO. Thus, this study systematically reviewed the literature on clinical and patient-reported outcomes of pain management strategies for patients after HTO.
METHODS: A comprehensive search of the PubMed, Cochrane CENTRAL, and CINAHL databases was conducted from inception through September 2023. Studies were included if they evaluated pain reduction with analgesia strategies after HTO and were excluded if they did not report pain control outcomes.
RESULTS: Five studies with 217 patients were included. Patients with a multimodal intraoperative injection cocktail to the knee, femoral nerve block (FNB), or adductor canal block (ACB) for HTO had significant improvement in visual analog scale (VAS) and numerical rating scale (NRS) scores in the first 12 h postoperatively compared to controls. Patients on duloxetine had significantly lower NRS scores at 1, 7, and 14 days postoperatively and significantly lower nonsteroidal anti-inflammatory drug (NSAID) usage throughout the two-week postoperative period than the control group. Patients receiving an ACB had significantly lower opioid consumption than controls at 12 h postoperative. In patients with an FNB or ACB, no significant difference in quadriceps strength or time to straight leg raise postoperatively was observed compared to controls.
CONCLUSIONS: A multimodal periarticular injection cocktail, FNB, or an ACB effectively reduces pain on the first day after HTO, with an ACB able to reduce opioid consumption on the first postoperative day. Duloxetine combined with an ACB effectively decreases pain for two weeks postoperatively while reducing NSAID consumption in patients after HTO.
METHODS: IV.
METHODS: A comprehensive search of the PubMed, Cochrane CENTRAL, and CINAHL databases was conducted from inception through September 2023. Studies were included if they evaluated pain reduction with analgesia strategies after HTO and were excluded if they did not report pain control outcomes.
RESULTS: Five studies with 217 patients were included. Patients with a multimodal intraoperative injection cocktail to the knee, femoral nerve block (FNB), or adductor canal block (ACB) for HTO had significant improvement in visual analog scale (VAS) and numerical rating scale (NRS) scores in the first 12 h postoperatively compared to controls. Patients on duloxetine had significantly lower NRS scores at 1, 7, and 14 days postoperatively and significantly lower nonsteroidal anti-inflammatory drug (NSAID) usage throughout the two-week postoperative period than the control group. Patients receiving an ACB had significantly lower opioid consumption than controls at 12 h postoperative. In patients with an FNB or ACB, no significant difference in quadriceps strength or time to straight leg raise postoperatively was observed compared to controls.
CONCLUSIONS: A multimodal periarticular injection cocktail, FNB, or an ACB effectively reduces pain on the first day after HTO, with an ACB able to reduce opioid consumption on the first postoperative day. Duloxetine combined with an ACB effectively decreases pain for two weeks postoperatively while reducing NSAID consumption in patients after HTO.
METHODS: IV.
摘要：
目的：对HTO术后最佳镇痛方案知之甚少。因此，本研究系统回顾了有关HTO术后患者疼痛管理策略的临床和患者报告结局的文献.
方法：对PubMed的全面搜索，科克伦中部,和CINAHL数据库从成立到2023年9月进行。如果他们在HTO后使用镇痛策略评估疼痛减轻，则包括研究，如果他们没有报告疼痛控制结果，则排除研究。
结果：纳入了涉及217名患者的5项研究。对膝盖进行多模式术中注射鸡尾酒的患者，股神经阻滞(FNB),与对照组相比，HTO的内收肌管阻滞（ACB）在术后前12小时的视觉模拟量表（VAS）和数字评定量表（NRS）评分均有显着改善。与对照组相比，接受度洛西汀治疗的患者在术后1、7和14天的NRS评分显着降低，并且在术后两周内非甾体抗炎药（NSAID）的使用量显着降低。接受ACB的患者在术后12小时的阿片类药物消耗量明显低于对照组。在FNB或ACB患者中，与对照组相比，术后股四头肌力量或直腿抬高时间没有显着差异。
结论：多模式关节周围注射鸡尾酒，FNB,或ACB在HTO后的第一天有效减轻疼痛，ACB能够在术后第一天减少阿片类药物的消耗。度洛西汀联合ACB可有效减轻术后两周的疼痛，同时减少HTO后患者的NSAID消耗。
方法：IV.
方法：对PubMed的全面搜索，科克伦中部,和CINAHL数据库从成立到2023年9月进行。如果他们在HTO后使用镇痛策略评估疼痛减轻，则包括研究，如果他们没有报告疼痛控制结果，则排除研究。
结果：纳入了涉及217名患者的5项研究。对膝盖进行多模式术中注射鸡尾酒的患者，股神经阻滞(FNB),与对照组相比，HTO的内收肌管阻滞（ACB）在术后前12小时的视觉模拟量表（VAS）和数字评定量表（NRS）评分均有显着改善。与对照组相比，接受度洛西汀治疗的患者在术后1、7和14天的NRS评分显着降低，并且在术后两周内非甾体抗炎药（NSAID）的使用量显着降低。接受ACB的患者在术后12小时的阿片类药物消耗量明显低于对照组。在FNB或ACB患者中，与对照组相比，术后股四头肌力量或直腿抬高时间没有显着差异。
结论：多模式关节周围注射鸡尾酒，FNB,或ACB在HTO后的第一天有效减轻疼痛，ACB能够在术后第一天减少阿片类药物的消耗。度洛西汀联合ACB可有效减轻术后两周的疼痛，同时减少HTO后患者的NSAID消耗。
方法：IV.
