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作 者:陈永权[1] 金孝岠[1] 朱美芳[1] 鲁卫华[1] 余俊马[2]
机构地区:[1]芜湖市皖南医学院弋矶山医院麻醉科,241001 [2]合肥市第一人民医院麻醉科
出 处:《实用疼痛学杂志》2007年第3期183-185,共3页Pain Clinic Journal
基 金:皖南医学院中青年科研基金(NO WK200428A)资助
摘 要:目的观察膝关节手术后关节腔内应用不同镇痛药物的临床效果。方法75例硬膜外麻醉下行膝关节镜手术患者,随机分为5组(n=15),术后关节腔内注入不同的药物分别为:生理盐水,吗啡1 mg,曲马朵10 mg,氯胺酮10 mg,氯诺昔康5 mg。记录术后第2、4、8、12、24 h患者屈膝关节90°的视觉模拟评分(VAS)以及副作用。结果在2、24 h各组VAS评分差异无统计学意义(P>0.05);在4、8、12 h4组试验组VAS评分明显小于对照组(P<0.05或P<0.01),而试验组间VAS评分差异无统计学意义(P>0.05)。生理盐水组和吗啡组有1例患者出现短暂的尿潴留。结论4组试验组小剂量镇痛药关节腔内注射均可有效缓解膝关节手术的术后疼痛。Objective To evaluate the analgesic effect of different low-dose intra-articular analgesics after knee arthroscopy. Methods Seventy-five patients with ASA physical status Ⅰto Ⅱ ,undergoing knee arthroscopy, were randomly divided into 5 groups equally. All patients received continuous epidural anesthesia. At the end of surgery, the following drugs were injected intra-articularly through the arthroscope:normal saline group;morphine( 1 mg) group in saline; tramadol( 10 mg ) group in saline;ketamine (10 mg) group in saline; lornoxican (5 mg) group in saline. Visual analogue scale(VAS) immediately after the patient actively flexed the operated knee to 90 degree at postoperation of 2,4,8,12,24 h and the side effects were recorded. Results At 2 and 24 h there were no statistical difference in VAS among the groups (P〉0.05). At 4,8 and 12 h VAS were significantly lower in the groups of morphine,tramadol,ketamine and lomoxican than that in control group (P 〈0.05 or P 〈0.01 ), but there were no statistical difference in VAS among the groups of morphine, tramadol, ketamine and lomoxican ( P 〉0.05 ). One patient in groups of normal saline and morphine respectively had temporal urinary retention ,no other adverse effects were noted. Conclusion Different low-dose intra-articular analgesics can effectively relieve the pain after arthroscopic knee surgery.
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