临床与病理杂志2025，Vol.45Issue(7)：824-832,9.DOI:10.11817/j.issn.2095-6959.2025.250254
基于线性混合效应模型分析改良"鸡尾酒"配方对全膝关节置换术后的早期镇痛效果
Early analgesic effect of a modified"cocktail"formula after total knee arthroplasty based on a linear mixed-effects model
摘要
Abstract
Objective:Severe postoperative pain after total knee arthroplasty(TKA)requires multimodal analgesia during the perioperative period.Local infiltration analgesia(LIA)is one of the analgesic methods but has a short duration of effect.This study compared the early analgesic efficacy of traditional"cocktails"versus modified"cocktails"containing magnesium sulfate and sodium bicarbonate for LIA in TKA patients,using a linear mixed-effects model. Methods:This retrospective study included 193 patients who underwent TKA in the Department of Orthopedics at Wuwei People's Hospital from January 2024 to February 2025.The modified"cocktail",containing magnesium sulfate injection and sodium bicarbonate injection,was defined as the exposure factor.Patients receiving the modified"cocktail"were assigned to the experimental group(n=87),and those receiving the traditional"cocktail"were assigned to the control group(n=106).General information including gender,age,height,weight,body mass index(BMI),range of motion(ROM),Visual Analog Scale(VAS)pain score,American Society of Anesthesiologists(ASA)classification,operative side,and operative time was collected.The time to first oral oxycodone hydrochloride controlled-release tablets,the proportions of patients taking oxycodone at 12 hours,1 day,and 2 days postoperatively,and postoperative hospital stay were compared between the 2 groups.Repeated measurements of postoperative VAS scores at rest and during activity,as well as ROM,were used for linear mixed-effects model analysis. Results:A total of 193 patients were included.No statistically significant differences were observed between the 2 groups in baseline characteristics including gender,age,height,weight,BMI,ROM,VAS score,ASA classification,operative side,and operative time(all P>0.05).The interval to first oxycodone intake was significantly longer in the experimental group(P<0.05).The proportions of patients taking oxycodone at 12 hours and 1 day postoperatively were significantly lower in the experimental group than those in the control group(P<0.05),while no significant difference was observed at 2 days postoperatively(P>0.05).Postoperative hospital stay showed no significant difference between the 2 groups(P>0.05).Linear mixed-effects model analysis indicated significant group effects,time effects,and interaction effects between the 2 groups for VAS at rest(12-72 h postoperatively)and VAS during activity(12-72 h postoperatively)(all P<0.05).For postoperative ROM(24-72 h),significant group effects,time effects,and interaction effects were also observed(all P<0.05).The incidence of postoperative complications did not differ significantly between the 2 groups(P>0.05). Conclusion:Compared with the traditional"cocktail",the modified"cocktail"containing magnesium sulfate and sodium bicarbonate can reduce early postoperative pain,decrease early oxycodone consumption,and improve early ROM in TKA patients,although it does not significantly shorten postoperative hospital stay.关键词
硫酸镁/碳酸氢钠/"鸡尾酒"疗法/全膝关节置换术/线性混合效应模型Key words
magnesium sulfate/sodium bicarbonate/"cocktail"therapy/total knee arthroplasty/linear mixed-effects model引用本文复制引用
张东亮,权朝颖,黄国源,牛存良..基于线性混合效应模型分析改良"鸡尾酒"配方对全膝关节置换术后的早期镇痛效果[J].临床与病理杂志,2025,45(7):824-832,9.基金项目
武威市科技计划B项目(WW24B01SF069).This work was supported by the Project B of Wuwei Science and Technology Plan,China(WW24B01SF069). （WW24B01SF069）
