ABSTRACT
OBJECTIVES: This study was to compare the effects of different local analgesia protocols on osteoarthritis patients undergoing total knee arthroplasty (TKA). METHODS: Medical records of 148 osteoarthritis patients who underwent unilateral TKA between October 2016 and October 2017 in our hospital were retrospectively analyzed. All these patients were divided into three groups according to the pain management protocol (morphine, morphine + cocktail [100 mg ropivacaine, 10 mg morphine, and 30 mL 0.9% sodium chloride solution containing 2 mL betamethasone (4 mg)], or cocktail). The postoperative visual analog scale (VAS) score, muscle strength, and complications were compared between the groups. RESULTS: At 6 and 12 hours post-operation, the VAS score in group C was significantly higher than that in group A or group B. In addition, the muscle (quadriceps femoris) strength score of group C (3.7 ± 2.8) was significantly higher than that in groups A and B at 6 and 12 hours post-operation. The VAS score and muscle strength score showed no significant differences among the three groups at 24 and 36 hours post-operation. The time of postoperative first void of group C was significantly shorter than that of groups A and B. Groups A or B had a significantly higher incidence of nausea and emesis compared with group C. The incidence of pruritus was higher in groups A or B than that in group C. CONCLUSION: Epidural anesthesia combined with local analgesic cocktail injection is a preferable effective multimodal analgesia for TKA.
Subject(s)
Analgesia , Arthroplasty, Replacement, Knee , Osteoarthritis , Analgesics, Opioid , Anesthetics, Local , Arthroplasty, Replacement, Knee/adverse effects , Double-Blind Method , Humans , Morphine , Osteoarthritis/complications , Pain Management , Pain, Postoperative/drug therapy , Pain, Postoperative/etiology , Pain, Postoperative/prevention & control , Retrospective StudiesABSTRACT
LncRNA PlncRNA-1(PlncRNA-1) participates in breast cancer by upregulating TGF-ß1. It is known that TGF-ß1 plays an inhibitory role in the inflammatory responses in rheumatoid arthritis (RA). Therefore, PlncRNA-1 may also participate in RA. Serum and synovial fibroblasts were obtained from 34 patients with active RA (persistent symptoms), 36 patients with inactive RA (long term of no or few symptoms after active RA) and 40 healthy controls. Expression levels of PlncRNA-1 and TGF-ß1 in active RA patients, inactive RA patients and healthy controls were measured by RT-qPCR and ELISA, respectively. Pearson Correlation Coefficient was used to determine the correlation between the expression levels of PlncRNA-1 and TGF-ß1. Diagnostic value of PlncRNA-1 for active RA was detected by ROC curve analysis. PlncRNA-1 and TGF-ß1 were downregulated in serum of active RA patients but not in inactive RA patients compared to the healthy controls. Expression of PlncRNA-1 and TGF-ß1 were positively correlated only in RA patients, and altered expression levels of PlncRNA-1 distinguished the active RA patients from inactive RA patients and healthy controls. PlncRNA-1 and TGF-ß1 were also downregulated in synovial fibroblasts derived from RA patients in comparison to inactive RA patients and healthy controls. Overexpression of PlncRNA-1 mediated upregulation of TGF-ß1 in synovial fibroblasts derived from RA patients, while exogenous TGF-ß1 treatment showed no significant effect on the expression of PlncRNA-1. Therefore, PlncRNA-1 participated in RA possibly by regulating TGF-ß1.
