局麻膝关节镜围手术期疼痛控制研究  

Pain control during arthroscopy knee joint perioperation under local anesthesia

作　　者：陈旭[1] 刘玉杰[1] 王志刚[1] 李众利[1] 魏民[1] 王晓[1] 朱娟丽[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《军医进修学院学报》2010年第10期967-969,共3页Academic Journal of Pla Postgraduate Medical School

基　　金：国家"863"计划项目(2007AA021902)~~

摘　　要：目的研究罗哌卡因与氟比洛芬酯两种药物在局麻膝关节镜围手术期的镇痛效果。方法将72例膝关节镜局麻手术患者随机分为安慰剂(P)组:脂肪乳+0.9%氯化钠注射液;氟比洛芬酯(F)组:氟比洛芬酯+0.9%氯化钠注射液;罗哌卡因(R)组:罗哌卡因+脂肪乳;联合应用(C)组:氟比洛芬酯+罗哌卡因。比较4组术中和术后1、2、4、8、12、24h的疼痛视觉模拟评分(Visual Analog Scale,VAS)、不良反应发生率、补充性曲马多用量及时间、患者满意度以评价各组的临床效果。结果术后2、4h静息和运动时罗哌卡因、氟比洛芬酯均有效且两种药物具有协同作用,术后8h静息和运动时只有氟比洛芬酯有效。术后1、12、24h时各组VAS评分无统计学差异。F组与P组行射频消融术时VAS评分差异有统计学意义(P=0.015)。结论氟比洛芬酯超前镇痛在局麻膝关节镜围手术期具有良好的镇痛效果,联合应用罗哌卡因在术后早期具有协同作用。Objective To study the analgesic effects of ropivacaine and furbiprofen axetil during arthroscopy knee joint perioperation under local anesthesia. Methods Seventy-two patients who were to undergo arthroscopy knee joint operation under local anesthesia were randomized into group P（placebo）, group F（furbiprofen axetil）,group R（repivacaine） and group C（combined furbiprofen axetil and repivacaine）. Visual analog scale（VAS）, incidence of side effects, dosage and time of supplementary tramadol and satisfaction degree of patients were compared during and 1, 2, 4, 8, 12 and 24h after operation to evaluate their pain control effect in different groups. Results Furbiprofen axetil and repivacaine effectively controlled the pain and exhibited a synergic effect 2 and 4h after operation. However, only furbiprofen axetil could effectively control the pain at rest and exercise 8h after operation. No difference was found in VAS among different groups 1, 12 and 24h after operation, but a significant difference was observed during radiofrequency between groups P and F（P=0.015）. Conclusion Furbiprofen axetil has a rather good analgesic effect on pain during arthroscopy knee joint operation under local anesthesia. Combined furbiprofen axetil and repivacaine has a synergic effect on pain early after operation.

关 键 词：关节镜 膝 麻醉 局部 镇痛 

分 类 号：R684[医药卫生—骨科学]