髋关节镜检查术后早期的疼痛评分与活动耐受性
Pain Scores and Activity Tolerance in the Early Postoperative Period After Hip Arthroscopy.
作者信息
Ramos Laylaa, Kraeutler Matthew J, Marty Eric, Welton K Linnea, Garabekyan Tigran, Mei-Dan Omer
机构信息
Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA.
Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey, USA.
出版信息
Orthop J Sports Med. 2020 Oct 28;8(10):2325967120960689. doi: 10.1177/2325967120960689. eCollection 2020 Oct.
BACKGROUND
Despite the rapid growth in the use of hip arthroscopy, standardized data on postoperative pain scores and activity level are lacking.
PURPOSE
To quantify narcotic consumption and use of the stationary bicycle in the early postoperative period after hip arthroscopy.
STUDY DESIGN
Case series; Level of evidence, 4.
METHODS
In this prospective case series, patients undergoing a primary hip arthroscopy procedure by a single surgeon were asked to fill out a daily survey for 9 days postoperatively. Patients were asked to report their pain level each day on a visual analog scale from 1 to 10, along with the amount of narcotic pain pills they used during those postoperative days (PODs). Narcotic usage was converted to a morphine-equivalent dosage (MED) for each patient. Patients were also instructed to cycle daily starting on the night of surgery for a minimum of 3 minutes twice per day and were asked to rate their pain as a percentage of their preoperative pain level and the number of minutes spent cycling on a stationary bicycle per day.
RESULTS
A total of 212 patients were enrolled in this study. Pain levels (POD1, 5.5; POD4, 3.8; POD9, 2.9; < .0001) and the percentage of preoperative pain (POD1, 51.6%; POD4, 31.8%; POD9, 29.5%; < .01) significantly decreased over the study period. The amount of narcotics used per day (reported in MED) also significantly decreased (POD1, 27.3; POD4, 22.3; POD9, 8.5; < .0001). By POD4, 41% of patients had discontinued all narcotics, and by POD9, 65% of patients were completely off narcotic medication. Patients were able to significantly increase the number of minutes spent cycling each day (POD1, 7.6 minutes; POD4, 13.8 minutes; POD9, 19.0 minutes; < .0001). Patients who received a preoperative narcotic prescription for the affected hip were significantly more likely to require an additional postoperative narcotic prescription ( < .001).
CONCLUSION
Patients can expect a rapid decrease in narcotic consumption along with a high degree of activity tolerance in the early postoperative period after hip arthroscopy.
背景
尽管髋关节镜检查的使用迅速增加，但术后疼痛评分和活动水平的标准化数据仍然缺乏。
目的
量化髋关节镜检查术后早期的麻醉药物消耗量和固定自行车的使用情况。
研究设计
病例系列；证据等级，4级。
方法
在这个前瞻性病例系列中，由单一外科医生进行初次髋关节镜手术的患者被要求在术后9天内每天填写一份调查问卷。患者被要求每天用1至10的视觉模拟量表报告他们的疼痛程度，以及他们在术后这些天（POD）使用的麻醉性止痛片的数量。每位患者的麻醉药物用量被换算成吗啡当量剂量（MED）。患者还被指示从手术当晚开始每天骑自行车，每天至少两次，每次至少3分钟，并要求他们将疼痛程度评定为术前疼痛水平的百分比以及每天在固定自行车上骑行的分钟数。
结果
本研究共纳入212例患者。在研究期间，疼痛程度（术后第1天，5.5；术后第4天，3.8；术后第9天，2.9；P<0.0001）和术前疼痛的百分比（术后第1天，51.6%；术后第4天，31.8%；术后第9天，29.5%；P<0.01）显著下降。每天使用的麻醉药物量（以MED报告）也显著下降（术后第1天，27.3；术后第4天，22.3；术后第9天，8.5；P<0.0001）。到术后第4天，41%的患者停止使用所有麻醉药物，到术后第9天，65%的患者完全停用麻醉药物。患者每天能够显著增加骑行的分钟数（术后第1天，7.6分钟；术后第4天，13.8分钟；术后第9天，19.0分钟；P<0.00
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