Management of Postoperative Pain After Arthroscopic Elbow Surgery with Oral Analgesics and Local Anesthesia

Summary

Here, we present a protocol for combined oral and local analgesia that effectively relieves post-arthroscopic elbow surgery pain and merits clinical promotion.

Abstract

Pain after arthroscopic elbow surgery seriously impairs patients’ quality of life, and its clinical management remains a significant challenge at present. Objective: This study aims to analyse the efficacy of oral analgesia and local anaesthesia in the management of pain levels after arthroscopic elbow surgery. Methods: A single-center retrospective observational study was conducted. A total of 120 patients with postoperative pain after arthroscopic elbow surgery were recruited from Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province between December 2020 and December 2023. The patients were divided into two groups with 60 cases in each group: the LA group received local anaesthesia alone, while the LC group was administered local anaesthesia combined with oral Celecoxib capsules. The treatment cycle was 3-5 days. The main assessments were pain level (VAS score), Ramsay sedation score, elbow function (MEPS score), and clinical efficacy in both groups. Secondary outcomes included stress factor levels [malondialdehyde (MDA), aldosterone (ALD)], patient satisfaction, quality of life [Short Form of the Health Status Survey (SF-36) score], complication status, and incidence of adverse effects. Results: After treatment, the indicators of the both groups were significantly differences with pre-treatment (P<0.05). Ramsay score, MEPS score, elbow mobility, clinical efficacy, SF-36 score and satisfaction score were significantly higher the LA group, and VAS score, MDA and ALD levels, total complication rate and adverse reaction rate were significantly lower the LA group (P<0.05).

Introduction

With the implementation of the national strategies of 'Healthy China' and 'National Fitness', the number of fitness enthusiasts is increasing. However, due to insufficient knowledge of sports medicine and rehabilitation medicine, coupled with chronic repetitive upper limb load related to fitness and professional activities, the incidence rate of elbow disorders in the population continues to rise¹. Among them, the incidence of primary elbow osteoarthritis with stiffness is about 2%, and the incidence is as high as 33% in the occupational groups (e.g., chefs, throwers, etc.) that have been engaged in long-term loading of the uppe....

Protocol

The study was conducted in compliance with the Declaration of Helsinki and the hospital's ethical guidelines and was endorsed by the ethical committees of Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine. Written informed consent was obtained from every participant in this study.

1. Study design and participants

NOTE: The present study is a single-center retrospective observational study involving 120 patients with postoperative pain after arthroscopic elbow surgery admitted to Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine between D....

Results

Basic information
In this study, 120 patients with postoperative pain after arthroscopic elbow surgery from Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine between December 2020 and December 2023 were divided into LA (n = 60) and LC (n = 60) groups based on different interventions. The baseline demographic and baseline characteristics of the patients in both groups are presented in Table 1, and these characteristics revealed no signifi.......

Discussion

As one of the most mobile compound joints in the body, the elbow joint is susceptible to trauma, degeneration, and inflammatory diseases. According to epidemiological investigations, osteoarthritis, free body, and post-traumatic stiffness are the most common among different degrees of elbow dysfunction²². The prevalence of post-traumatic elbow stiffness is as high as 30%, and although traditional open surgery can release adhesions, it is traumatic, has a long recovery period, and carries a signifi.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Lidocaine	Shanghai Chaohui Pharmaceutical Co., Ltd	H31021071
NaCl	Shanghai Baxter Medical Supplies Co., Ltd.	H19983149
Epinephrine hydrochloride	Shanghai WoFeng Pharmaceutical Co., Ltd.	H31021062
Celecoxib capsule	Qingdao Baiyang Pharmaceutical Co., Ltd	H20203325
Beckman Coulter chemistry analyser	Beckman Coulter Inc.	AU5800