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Total Diz Artroplastisinde Periartiküler Enjeksiyon Deneyimlerimiz

Year 2018, Volume: 15 Issue: 3, 190 - 193, 12.12.2018

Abstract

Amaç: Bu çalışmada amacımız, total diz artroplastisinde periartiküler enjeksiyonun ameliyat sonrası ağrı kontrolündeki etkilerini araştırmak ve deneyimlerimizi paylaşmaktır.

Materyal ve Metod: Çalışmamıza Mart 2013-Aralık 2015 tarihleri arasında diz osteoartriti tanılı, TDA elektif cerrahisi geçiren 110 hasta dahil edildi. Hastalara implantasyondan sonra 20 mL %0,5 bupivakain HC1 (toplam 100 mg) periartiküler enjeksiyon uygulandı. Hastaların postoperatif ağrı düzeyleri görsel analog skalası (Visuel Analog Scala, VAS) ile postoperatif 30 dk ve 1, 2, 4 ve 6. saatlerde değerlendirildi. Ağrı şikâyeti olan hastalara tek doz Petidin HC1 0,1 mg / kg IM yapıldı.

Bulgular: Hastaların yaş ortalaması 64, en genç hasta 53, en yaşlı hasta 72 yaşında idi. Kadın hasta sayısı daha fazla idi. Vücut kitle indeksi (VKİ) ortalaması 24 bulundu. Hastaların VAS değerleri ortalamaları 30. dk’da 3.9, 1. saatte 4.3, 2. saatte 4.5, 4. saatte 5.3, 6. saatte ise 6.1 idi.

Sonuç: TDA sonrası periartiküler bupivakain enjeksiyonunun postoperatif analjezi sağladığını göstermektedir.

References

  • 1. Specht K, KjaersgaardAndersen P, Kehlet H, Wedderkopp N, Pedersen BD. High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement. Acta Orthop. 2015;86(6):702-7.2. Song MH, Kim BH, Ahn SJ, Yoo SH, Kang SW, Kim YJ, et al. Peri-articular injections of local anaesthesia can replace patient-controlled analgesia after total knee arthroplasty: a randomised controlled study. Int Orthop. 2016;40(2):295-9.3. Fu P, Wu Y, Wu H, Li X, Qian Q, Zhu Y. Efficacy of intra-articular cocktail analgesic injection in total knee arthroplasty - a randomized controlled trial. Knee. 2009;16(4):280-4.4. Andersen LJ, Poulsen T, Krogh B, Nielsen T. Postoperative analgesia in total hip arthroplasty: a randomized double-blinded, placebo-controlled study on peroperative and postoperative ropivacaine, ketorolac, and adrenaline wound infiltration. Acta Orthop. 2007;78(2):187-92.5. Albert TJ, Cohn JC, Rothman JS, Springstead J, Rothman RH, Booth RE Jr. Patient-controlled analgesia in a postoperative total joint arthroplasty population. J Arthroplasty. 1991;6 (Suppl):23-8.6. Singelyn FJ, Gouverneur JM. Postoperative analgesia after total hip arthroplasty: i.v. PCAwith morphine, patient-controlled epidural analgesia, or continuous "3-in-1" block?: a prospective evaluation by our acute pain service in more than 1,300 patients. J Clin Anesth. 1999;11(7):550-4.7. Avramov MN, Badrinath S. Anesthesia and postoperative pain. In: Miller MD, Cole BJ (eds) Textbook of arthroscopy. Saunders, Philadelphia, 2004: 55–62.8. Busch CA, Shore BJ, Bhandari R, et al. Efficacy of periarticular multimodal drug injection in total knee arthroplasty. A randomized trial. J Bone Joint Surg Am. 2006;88(5):959–63.9. Eroglu A, Saracoglu S, Erturk E, Kosucu M, Kerimoglu S. A comparison of intraarticular morphine and bupivacaine for pain control and outpatient status after anarthroscopic knee surgery under a low dose of spinal anaesthesia. Knee Surg Sports Traumatol Arthrosc. 2010;18(11):1487-95.10. Lohsiriwat V, Lert-akyamanee N, Rushatamukayanunt W. Efficacy of pre-incisional bupivacaine infiltration on postoperative pain relief after appendectomy: prospective double-blind randomized trial. World J Surg. 2004;28(10):947-50.11. Chaumeron A, Audy D, Drolet P, Lavigne M, Vendittoli PA. Periarticular injection in knee arthroplasty improves quadriceps function. Clin Orthop Relat Res. 2013;471(7):2284-95. 12. Fischer HB, Simanski CJ, Sharp C, Bonnet F, Camu F, Neugebauer EA, Rawal N, Joshi GP, Schug SA, Kehlet H; PROSPECT Working Group. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty. Anaesthesia. 2008;63(10):1105-23.13. Yuenyongviwat V, Pornrattanamaneewong C, Chinachoti T, Chareancholvanich K. Periarticular injection with bupivacaine for postoperative pain control in total knee replacement: a prospective randomized double-blind controlled trial. Adv Orthop. 2012;2012:107309.14. Beyzadeoglu T, Yilmaz C, Bekler H, Gokce A, Sayin MM. Intraarticular tramadol plus pericapsular incisional bupivacaine provides better analgesia than intraarticular pluspericapsular incisional bupivacaine after outpatient arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):564-8.15. Kerr DR, Kohan L. Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of 325 patients. Acta Orthop. 2008;79(2):174-83.16. Parvataneni HK, Shah VP, Howard H, Cole N, Ranawat AS, Ranawat CS. Controlling pain after total hip and knee arthroplasty using a multimodal protocol with local periarticular injections: a prospective randomized study. J Arthroplasty. 2007;22(suppl 2):33-8.17. Ertürk C, Altay MA, Altay N, et al. Will a single periarticular lidocaine–corticosteroid injection improve the clinical efficacy of intraarticular hyaluronic acid treatment of symptomatic knee osteoarthritis? Knee Surg Sports Traumatol Arthrosc. 2016 ;24 (11):3653-60.

Periarticular Injection Experience in Total Knee Arthroplasty

Year 2018, Volume: 15 Issue: 3, 190 - 193, 12.12.2018

Abstract

Background: The aim of this study was to investigate the effects of periarticular injection on postoperative pain control in total knee arthroplasty and to share our experience.

Material and Methods: Between March 2013 and December 2015, 110 patients with knee osteoarthritis who underwent TDA elective surgery were included in our study. Patients underwent periarticular injection of 20 mL of 0.5% bupivacaine HCl (100 mg total) after implantation. Postoperative pain levels of the patients were evaluated with visual analog scale (Visuel Analog Scala, VAS) and postoperative 30 min and 1, 2, 4 and 6 hours.

Results: The mean age of the patients was 64 years, the youngest patient was 53 years and the oldest patient was 72 years old. The number of female patients was higher. The body mass index (BMI) average was 24. The mean VAS values of the patients were 3.9 at 30 minutes, 4.3 at the 1st hour, 4.5 at the second hour, 5.3 at the 4th hour and 6.1 at the 6th hour. Patients with pain administered one dose of Pethidine HCl 0.1 mg / kg IM

Conclusions: It shows that postoperative periarticular bupivacaine injection provides postoperative analgesia after TKA.

References

  • 1. Specht K, KjaersgaardAndersen P, Kehlet H, Wedderkopp N, Pedersen BD. High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement. Acta Orthop. 2015;86(6):702-7.2. Song MH, Kim BH, Ahn SJ, Yoo SH, Kang SW, Kim YJ, et al. Peri-articular injections of local anaesthesia can replace patient-controlled analgesia after total knee arthroplasty: a randomised controlled study. Int Orthop. 2016;40(2):295-9.3. Fu P, Wu Y, Wu H, Li X, Qian Q, Zhu Y. Efficacy of intra-articular cocktail analgesic injection in total knee arthroplasty - a randomized controlled trial. Knee. 2009;16(4):280-4.4. Andersen LJ, Poulsen T, Krogh B, Nielsen T. Postoperative analgesia in total hip arthroplasty: a randomized double-blinded, placebo-controlled study on peroperative and postoperative ropivacaine, ketorolac, and adrenaline wound infiltration. Acta Orthop. 2007;78(2):187-92.5. Albert TJ, Cohn JC, Rothman JS, Springstead J, Rothman RH, Booth RE Jr. Patient-controlled analgesia in a postoperative total joint arthroplasty population. J Arthroplasty. 1991;6 (Suppl):23-8.6. Singelyn FJ, Gouverneur JM. Postoperative analgesia after total hip arthroplasty: i.v. PCAwith morphine, patient-controlled epidural analgesia, or continuous "3-in-1" block?: a prospective evaluation by our acute pain service in more than 1,300 patients. J Clin Anesth. 1999;11(7):550-4.7. Avramov MN, Badrinath S. Anesthesia and postoperative pain. In: Miller MD, Cole BJ (eds) Textbook of arthroscopy. Saunders, Philadelphia, 2004: 55–62.8. Busch CA, Shore BJ, Bhandari R, et al. Efficacy of periarticular multimodal drug injection in total knee arthroplasty. A randomized trial. J Bone Joint Surg Am. 2006;88(5):959–63.9. Eroglu A, Saracoglu S, Erturk E, Kosucu M, Kerimoglu S. A comparison of intraarticular morphine and bupivacaine for pain control and outpatient status after anarthroscopic knee surgery under a low dose of spinal anaesthesia. Knee Surg Sports Traumatol Arthrosc. 2010;18(11):1487-95.10. Lohsiriwat V, Lert-akyamanee N, Rushatamukayanunt W. Efficacy of pre-incisional bupivacaine infiltration on postoperative pain relief after appendectomy: prospective double-blind randomized trial. World J Surg. 2004;28(10):947-50.11. Chaumeron A, Audy D, Drolet P, Lavigne M, Vendittoli PA. Periarticular injection in knee arthroplasty improves quadriceps function. Clin Orthop Relat Res. 2013;471(7):2284-95. 12. Fischer HB, Simanski CJ, Sharp C, Bonnet F, Camu F, Neugebauer EA, Rawal N, Joshi GP, Schug SA, Kehlet H; PROSPECT Working Group. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty. Anaesthesia. 2008;63(10):1105-23.13. Yuenyongviwat V, Pornrattanamaneewong C, Chinachoti T, Chareancholvanich K. Periarticular injection with bupivacaine for postoperative pain control in total knee replacement: a prospective randomized double-blind controlled trial. Adv Orthop. 2012;2012:107309.14. Beyzadeoglu T, Yilmaz C, Bekler H, Gokce A, Sayin MM. Intraarticular tramadol plus pericapsular incisional bupivacaine provides better analgesia than intraarticular pluspericapsular incisional bupivacaine after outpatient arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):564-8.15. Kerr DR, Kohan L. Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of 325 patients. Acta Orthop. 2008;79(2):174-83.16. Parvataneni HK, Shah VP, Howard H, Cole N, Ranawat AS, Ranawat CS. Controlling pain after total hip and knee arthroplasty using a multimodal protocol with local periarticular injections: a prospective randomized study. J Arthroplasty. 2007;22(suppl 2):33-8.17. Ertürk C, Altay MA, Altay N, et al. Will a single periarticular lidocaine–corticosteroid injection improve the clinical efficacy of intraarticular hyaluronic acid treatment of symptomatic knee osteoarthritis? Knee Surg Sports Traumatol Arthrosc. 2016 ;24 (11):3653-60.
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Details

Primary Language Turkish
Journal Section Research Article
Authors

Nuray Altay 0000-0002-7111-7893

Mehmet Akif Altay 0000-0001-9164-6090

Evren Büyükfırat 0000-0002-6396-0426

Mahmut Alp Karahan 0000-0002-7210-9481

Publication Date December 12, 2018
Submission Date October 17, 2018
Acceptance Date November 1, 2018
Published in Issue Year 2018 Volume: 15 Issue: 3

Cite

Vancouver Altay N, Altay MA, Büyükfırat E, Karahan MA. Total Diz Artroplastisinde Periartiküler Enjeksiyon Deneyimlerimiz. Harran Üniversitesi Tıp Fakültesi Dergisi. 2018;15(3):190-3.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty