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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(02): 252-256
DOI: 10.1055/s-0042-1744294
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A eficácia da infiltração periarticular anestésica na analgesia pós-operatória de artroplastia total do quadril[*]

Artikel in mehreren Sprachen: português | English
Rafael Wei Min Leal Chang 
1   Serviço de Ortopedia e Traumatologia do Hospital Universitário Getúlio Vargas (HUGV), Universidade Federal do Amazonas (UFAM), Manaus, AM, Brasil
,
Juscimar Carneiro Nunes 
2   Faculdade de Medicina da UFAM e Universidade do Estado do Amazonas, Manaus, AM, Brasil
3   Hospital Universitário Getúlio Vargas (HUGV), Universidade Federal do Amazonas (UFAM), Manaus, AM, Brasil
,
Bruno Bellaguarda Batista 
1   Serviço de Ortopedia e Traumatologia do Hospital Universitário Getúlio Vargas (HUGV), Universidade Federal do Amazonas (UFAM), Manaus, AM, Brasil
,
Thiago Couto Valle Bomfim de Borborema 
1   Serviço de Ortopedia e Traumatologia do Hospital Universitário Getúlio Vargas (HUGV), Universidade Federal do Amazonas (UFAM), Manaus, AM, Brasil
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Resumo

Objetivo Este estudo tem como objetivo avaliar a eficácia da técnica de infiltração periarticular do quadril no pós-operatório de artroplastia total do quadril.

Métodos Estudo clínico randomizado duplo-cego controlado. O estudo foi realizado nos pacientes com fratura de colo femoral ou osteoartrose de quadril, submetidos ao procedimento cirúrgico de artroplastia total do quadril em nossa instituição. A técnica de infiltração periarticular consistiu na aplicação da combinação de um anestésico (levobupivacaína) com um corticosteroide (dexametasona) nos tecidos ricos em nociceptores do quadril, após a colocação dos implantes ortopédicos. No grupo controle, foi realizada infiltração de soro fisiológico 0,9% nos mesmos tecidos. Após 24 e 48 horas do procedimento, foram avaliados os quesitos de dor, amplitude de movimentos, uso de analgésicos opióides, presença de efeitos adversos, período do início da deambulação e o tempo total de hospitalização.

Resultados Trinta e quatro pacientes foram estatisticamente avaliados no estudo. Foi observada uma redução no consumo de opioides entre 24 e 48 h no grupo experimental. Uma redução maior da pontuação de dor foi observada no grupo placebo.

Conclusão A infiltração periarticular anestésica como método de analgesia pós-operatória de artroplastia total do quadril, neste estudo, reduziu as taxas de consumo de opioides quando comparamos a evolução entre 24 e 48h. Não houve benefícios quanto às taxas de dor, mobilidade, tempo de internação ou intercorrências com este método.

Palavras-chave

artroplastia de quadril - injeções intra-articulares - analgesia - reabilitação

* Trabalho desenvolvido no Getúlio Vargas (HUGV), Universidade Federal do Amazonas (UFAM), Manaus, AM, Brasil.




Publikationsverlauf

Eingereicht: 08. September 2021

Angenommen: 20. Januar 2022

Artikel online veröffentlicht:
22. Juli 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 James WH, John RCJ. Arthroplasty of the hip. In: Azar FM, Beaty JH, Canale ST. Campbell's operative orthopaedics. 13th ed.. Philadelphia: Elsevier; 2017: 188-389
    Suche in Google Scholar
  • 2 Balik MS, Hocaoğlu Ç, Erkut A, Güvercin Y, Keskin D. Evaluation of the Quality of Life and Psychiatric Symptoms of Patients with Primary Coxarthrosis after Total Hip Arthroplasty. Acta Chir Orthop Traumatol Cech 2017; 84 (06) 436-440
    Suche in Google Scholar
  • 3 Rogmark C, Leonardsson O. Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients. Bone Joint J 2016; 98-B (03) 291-297
    Suche in Google Scholar
  • 4 Jiang J, Teng Y, Fan Z, Khan MS, Cui Z, Xia Y. The efficacy of periarticular multimodal drug injection for postoperative pain management in total knee or hip arthroplasty. J Arthroplasty 2013; 28 (10) 1882-1887
    Suche in Google Scholar
  • 5 Wang Y, Gao F, Sun W, Wang B, Guo W, Li Z. The efficacy of periarticular drug infiltration for postoperative pain after total hip arthroplasty: A systematic review and meta-analysis. Medicine (Baltimore) 2017; 96 (12) e6401
    Suche in Google Scholar
  • 6 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 (02) 174-183
    Suche in Google Scholar
  • 7 Andersen KV, Nikolajsen L, Daugaard H, Andersen NT, Haraldsted V, Søballe K. Local infiltration analgesia is not improved by postoperative intra-articular bolus injections for pain after total hip arthroplasty. Acta Orthop 2015; 86 (06) 647-653
    Suche in Google Scholar
  • 8 Chen DW, Hu CC, Chang YH, Lee MS, Chang CJ, Hsieh PH. Intra-articular bupivacaine reduces postoperative pain and meperidine use after total hip arthroplasty: a randomized, double-blind study. J Arthroplasty 2014; 29 (12) 2457-2461
    Suche in Google Scholar
  • 9 Kuchálik J, Granath B, Ljunggren A, Magnuson A, Lundin A, Gupta A. Postoperative pain relief after total hip arthroplasty: a randomized, double-blind comparison between intrathecal morphine and local infiltration analgesia. Br J Anaesth 2013; 111 (05) 793-799
    Suche in Google Scholar
  • 10 Lunn TH, Husted H, Solgaard S. et al. Intraoperative local infiltration analgesia for early analgesia after total hip arthroplasty: a randomized, double-blind, placebo-controlled trial. Reg Anesth Pain Med 2011; 36 (05) 424-429
    Suche in Google Scholar
  • 11 Marques EM, Jones HE, Elvers KT, Pyke M, Blom AW, Beswick AD. Local anaesthetic infiltration for peri-operative pain control in total hip and knee replacement: systematic review and meta-analyses of short- and long-term effectiveness. BMC Musculoskelet Disord 2014; 15: 220
    Suche in Google Scholar
  • 12 Pandazi A, Kanellopoulos I, Kalimeris K. et al. Periarticular infiltration for pain relief after total hip arthroplasty: a comparison with epidural and PCA analgesia. Arch Orthop Trauma Surg 2013; 133 (11) 1607-1612
    Suche in Google Scholar
  • 13 Andersen LØ, Kehlet H. Analgesic efficacy of local infiltration analgesia in hip and knee arthroplasty: a systematic review. Br J Anaesth 2014; 113 (03) 360-374
    Suche in Google Scholar
  • 14 Dobie I, Bennett D, Spence DJ, Murray JM, Beverland DE. Periarticular local anesthesia does not improve pain or mobility after THA. Clin Orthop Relat Res 2012; 470 (07) 1958-1965
    Suche in Google Scholar
  • 15 Hofstad JK, Winther SB, Rian T, Foss OA, Husby OS, Wik TS. Perioperative local infiltration anesthesia with ropivacaine has no effect on postoperative pain after total hip arthroplasty. Acta Orthop 2015; 86 (06) 654-658
    Suche in Google Scholar
  • 16 Ross JA, Greenwood AC, Sasser 3rd P, Jiranek WA. Periarticular Injections in Knee and Hip Arthroplasty: Where and What to Inject. J Arthroplasty 2017; 32 (9S): S77-S80
    Suche in Google Scholar
  • 17 Simons MJ, Amin NH, Cushner FD, Scuderi GR. Characterization of the Neural Anatomy in the Hip Joint to Optimize Periarticular Regional Anesthesia in Total Hip Arthroplasty. J Surg Orthop Adv 2015; 24 (04) 221-224
    Suche in Google Scholar
  • 18 Goesling J, Moser SE, Zaidi B. et al. Trends and predictors of opioid use after total knee and total hip arthroplasty. Pain 2016; 157 (06) 1259-1265
    Suche in Google Scholar
  • 19 Fahs AM, Koueiter DM, Kurdziel MD, Huynh KA, Perry CR, Verner JJ. Psoas Compartment Block vs Periarticular Local Anesthetic Infiltration for Pain Management After Anterior Total Hip Arthroplasty: A Prospective, Randomized Study. J Arthroplasty 2018; 33 (07) 2192-2196
    Suche in Google Scholar
  • 20 Ranjitkar S, Prakash R, Chookkalingam S, Prakash D. Periarticular injection of analgesia in primary total hip replacement: a prospective randomised single blind study. Nepal Med Coll J 2016; 18 (1–2): 32-36
    Suche in Google Scholar
  • 21 Jules-Elysee KM, Goon AK, Westrich GH. et al. Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study. J Bone Joint Surg Am 2015; 97 (10) 789-798
    Suche in Google Scholar