■全膝关节置换术(TKA)是一种标准的手术方法,适用于衰弱性膝关节炎患者。有效的术后疼痛管理对于成功康复至关重要,尽管传统的基于阿片类药物的方法有局限性。
■本研究旨在比较Apotel和瑞芬太尼患者自控镇痛在TKA术后疼痛管理中的疗效。
■这种双盲,随机化,在阿拉克的Amir-al-Momenin和Qods医院进行了对照临床试验,伊朗,从2022年6月到2023年9月。计划进行膝关节置换的62例符合条件的患者被随机分配接受Apotel(A组)或瑞芬太尼(R组)作为通过疼痛泵进行的多模式镇痛的一部分,以缓解TKA术后疼痛。这项研究评估了血液动力学参数,疼痛水平(使用视觉模拟量表测量),镇痛持续时间,和麻醉品消费。使用SPSSv.27和Plotly进行统计分析。
■受试者在年龄上没有统计学上的显着差异,性别分布,手术持续时间,或麻醉。恢复室的血流动力学状态评估显示SPO2、PR、或组间MAP。然而,与Apotel相比,瑞芬太尼在减轻TKA手术后24小时内的疼痛方面表现出优异的有效性,较低的平均视觉模拟量表(VAS)评分(P<0.001),持续时间更长,不需要麻醉止痛药(P<0.001),R组的累积阿片类镇痛药消耗量较低(P<0.001)。
■与Apotel相比,瑞芬太尼在多模式疼痛管理方法中表现出更好的疼痛控制,在手术后24小时内提供持续的疼痛减轻。此外,与Apotel相比,瑞芬太尼可提供更持久的疼痛缓解,并可降低麻醉性止痛药的累积消耗量.
UNASSIGNED: Total knee arthroplasty (TKA) is a standard surgical procedure for individuals with debilitating knee arthritis. Effective postoperative pain management is essential for successful recovery, although traditional opioid-based methods have limitations.
UNASSIGNED: This study aimed to compare the efficacy of Apotel and remifentanil patient-controlled analgesia in managing postoperative pain after TKA.
UNASSIGNED: This double-blind, randomized, controlled clinical trial took place at Amir-al-Momenin and Qods Hospitals in Arak, Iran, spanning from June 2022 to September 2023. Sixty-two eligible patients scheduled for knee joint replacement were randomly assigned to receive either Apotel (Group A) or remifentanil (Group R) as part of multimodal analgesia administered via a pain pump for postoperative pain relief in TKA. The study assessed hemodynamic parameters, pain levels (measured using the Visual Analog Scale), analgesic duration, and narcotic consumption. Statistical analyses were performed using SPSS v.27 and Plotly.
UNASSIGNED: Subjects exhibited no statistically significant differences in age, gender distribution, duration of surgery, or anesthesia. The hemodynamic status assessment in the recovery room showed no significant differences in SPO2, PR, or MAP between the groups. However, remifentanil demonstrated superior effectiveness in reducing pain over 24 hours post TKA surgery compared to Apotel, as evidenced by lower average Visual Analog Scale (VAS) scores (P < 0.001), longer duration without the need for narcotic painkillers (P < 0.001), and lower cumulative opioid analgesic consumption in Group R (P < 0.001).
UNASSIGNED: Remifentanil demonstrates superior pain control in a multimodal pain management approach compared to Apotel, providing sustained pain reduction over 24 hours post-surgery. Moreover, remifentanil offers longer-lasting pain relief and results in lower cumulative narcotic painkiller consumption compared to Apotel.