Double preemptive analgesia protocol for adolescents undergoing arthroscopic medial patellofemoral ligament reconstruction:A summary of perioperative effects
Objective To explore the effectiveness of a double preemptive analgesia protocol in the perioperative period for adolescents undergoing arthroscopic medial patellofemoral ligament(MPFL)re-construction.Methods Totally 104 adolescents with recurrent patellar dislocation and undergoing ar-throscopic MPFL reconstruction between April 2023 and November 2023 were analyzed retrospectively.Among them,47 were selected into a double preemptive analgesia(DPA)group,while the rest 57 were chosen into the control group.DPA group received preemptive analgesia on the days before and of the surgery,and the control group was given traditional perioperative and individualized postopera-tive analgesia.The Numerical Rating Scale(NRS)pain scores were recorded for both groups at admis-sion,right after returning to the ward postoperatively,at 6,12,24 and 48 hours after operation post-operatively,as well as at the time of the first attempt to bear weight.The time and frequency of res-cue analgesia,the time to the first straight leg raise,and the time to first bearing weight were record-ed for both groups.Moreover,adverse reactions were observed,and patient satisfaction scores were col-lected from family members before their discharge.Results There was no significant difference in pain scores between the two groups at admission.However,from 6 to 48 hours postoperatively,the NRS pain scores of DPA group were significantly lower than the control group at the same time points(P＜0.05).Moreover,compared with the control group,DPA group had significantly fewer times of rescue analgesia,higher patient satisfaction,and earlier time for first straight leg raise(P＜0.05).There were no severe postoperative complications in either DPA group or the control.However,mild adverse reac-tions occurred in 7(14.8％)of the DPA group and 8(14.1％)of the control group,mainly nausea,which mostly appeared on the day of surgery and improved without special treatment on the same day.Conclusions The double preemptive analgesia protocol can effectively reduce postoperative pain in ado-lescents undergoing arthroscopic MPFL reconstruction,accelerate postoperative recovery,enhance the confidence of adolescents and their families in rehabilitation,and improve satisfaction,providing a ref-erence for future clinical practice.
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