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Gonyautoxins 2/3 Local Periarticular Injection for Pain Management after Total Knee Arthroplasty: A Double-Blind, Randomized Study.
Hinzpeter, Jaime; Barahona, Maximiliano; Aliste, Julián; Barrientos, Cristian; Zamorano, Alvaro; Palet, Miguel; Catalan, Jaime; Campo, Miguel Del; Lagos, Néstor.
Afiliação
  • Hinzpeter J; Department of Orthopedics, Hospital Clinico Universidad de Chile, Santiago, Chile.
  • Barahona M; Department of Orthopedics, Hospital Clinico Universidad de Chile, Santiago, Chile.
  • Aliste J; Department of Anesthesiology and Perioperative Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile.
  • Barrientos C; Department of Orthopedics, Hospital Clinico Universidad de Chile, Santiago, Chile.
  • Zamorano A; Department of Orthopedics, Clínica Santa María, Santiago, Chile.
  • Palet M; Department of Orthopedics, Hospital Clinico Universidad de Chile, Santiago, Chile.
  • Catalan J; Department of Orthopedics, Hospital Clinico Universidad de Chile, Santiago, Chile.
  • Campo MD; Department of Orthopedics, Hospital Clinico Universidad de Chile, Santiago, Chile.
  • Lagos N; Membrane Biochemistry Laboratory, Department of Physiology and Biophysics, Faculty of Medicine Universidad de Chile, Santiago, Chile.
J Knee Surg ; 36(4): 389-396, 2023 Mar.
Article em En | MEDLINE | ID: mdl-34507361
The purpose of this study was to compare the efficacy of periarticular infiltration of gonyautoxin 2/3 (GTX 2/3) and a mixture of levobupivacaine, ketorolac, and epinephrine for pain management after total knee arthroplasty (TKA). Forty-eight patients were randomly allocated to receive periarticular infiltration of 40 µg GTX 2/3 (n = 24) diluted in 30 mL of sodium chloride 0.9% (study group) or a combination of 300 mg of levobupivacaine, 1 mg of epinephrine, and 60 mg ketorolac (n = 24) diluted in 150 mL of sodium chloride 0.9% (control group). Intraoperative anesthetic and surgical techniques were identical for both groups. Postoperatively, all patients received patient-controlled analgesia (morphine bolus of 1 mg; lockout interval of 8 minutes), acetaminophen, and ketoprofen for 72 hours. A blinded investigator recorded morphine consumption, which was the primary outcome. Also, the range of motion (ROM) and static and dynamic pain were assessed at 6, 12, 36, and 60 hours after surgery. The incidence of adverse events, time to readiness for discharge, and length of hospital stay were also recorded. The median of total cumulative morphine consumption was 16 mg (range, 0-62 mg) in the GTX 2/3 group and 9 mg (range, 0-54 mg) in control group, which did not reach statistical difference (median test, p = 0.40). Furthermore, static and dynamic pain scores were similar at all time intervals. GTX 2/3 was inferior in range of motion at 6 and 12 hours; nevertheless, we noted no difference after 36 hours. No differences between groups were found in terms of complications, side effects, or length of hospital stay. No significant differences were found between groups in terms of breakthrough morphine requirement. However, local anesthetic use resulted in an increased ROM in the first 12 hours. This prospective randomized clinical trial shows that GTX 2/3 is a safe and efficient drug for pain control after TKA; nevertheless, more studies using GTX 2/3 with larger populations are needed to confirm the safety profile and efficiency. This is level 1 therapeutic study, randomized, double-blind clinical trial.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia do Joelho Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: J Knee Surg Assunto da revista: ORTOPEDIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Chile País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia do Joelho Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: J Knee Surg Assunto da revista: ORTOPEDIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Chile País de publicação: Alemanha