کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4081029 1267576 2015 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Efficacy of multimodal analgesia injection combined with corticosteroids after arthroscopic rotator cuff repair
ترجمه فارسی عنوان
اثربخشی تزریق چند داروی موضعی با کورتیکواستروئیدها پس از درمان کراوات روتاتور آرتروسکوپی
کلمات کلیدی
مقاربت چند دارویی، آرتروسکوپی، تعمیر کتان روتاتور، درد پس از عمل، کورتیکواستروئیدها
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
چکیده انگلیسی

IntroductionAlthough arthroscopic rotator cuff repair is minimally invasive, there is still considerable postoperative pain, especially during the first 48 hours. The present study assessed the short-term efficacy and safety of multimodal analgesic (MMA) injection associated to corticosteroids in arthroscopic rotator cuff tear surgery.Material and methodA single-center prospective randomized study included 50 patients undergoing arthroscopic rotator cuff tear surgery. The study group received subacromial injection of a mixture of morphine, ropivacaine and methylprednisolone associated to intra-articular injection of morphine plus methylprednisolone; the control group received only isotonic saline. All patients had had 24 hours self-administered morphine associated to standard analgesia. Postoperative data were recorded at 30 minutes and 1, 2, 4, 6, 12, 18 and 24 hours: pain intensity, morphine intake and side effects, and also time to first morphine bolus and additional analgesic intake. Constant, ASES and SST functional scores were recorded at 3 months.ResultsPostoperative pain was significantly less intense in the MMA group than in controls at 30 min, H1, H4, H6, H12, H18 and H24 (P < 0.05). A rebound at D10 occurred in both groups. During the first 24 hours, MMA significantly reduced cumulative resort to morphine (P < 0.05 at H1/2, P < 0.001 at H1–24). Mean time to first bolus was significantly longer in the MMA group (71.6 vs. 33 min; P < 0.05). The rate of opioid-related side effects was similar between groups. At last follow-up, functional scores were similar between groups. There were no cases of infection or delayed skin healing.ConclusionMMA associated to corticosteroids after arthroscopic rotator cuff tear surgery provided immediate benefit in terms of analgesia and morphine sparing, without apparent risk of infection. The practice is presently little known in France and deserves longer-term assessment, especially as regards functional rehabilitation and tendon healing.Level of evidence2.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Orthopaedics & Traumatology: Surgery & Research - Volume 101, Issue 8, Supplement, December 2015, Pages S337–S345
نویسندگان
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