膝关节腔内注射罗哌卡因复合芬太尼用于膝关节镜术后镇痛的临床观察  

Observation on analgesic effects of intra-articular ropivacaine with fentanyl after knee arthroscopy

作　　者：张研[1] 黄增平[1] 于会群[1] 李娟[1] 戴莲青[1] 

机构地区：[1]深圳市中医院麻醉科,广东省深圳518033

出　　处：《中国基层医药》2011年第24期3344-3345,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 观察膝关节镜手术后关节腔内注射不同浓度罗哌卡因复合芬太尼的镇痛效果.方法 40例在腰麻-硬膜外联合阻滞下行单侧膝关节镜手术患者,随机分为四组,每组10例.术毕向关节腔内注入等容量（ 10 ml）的不同药物.F组芬太尼10μg；R组0.5％罗哌卡因；FR组芬太尼10μg＋0.5％罗哌卡因；N组0.9％氯化钠注射液.记录术后第2、4、8、12、24h患者在静息及运动状态（主动弯曲膝关节）的视觉疼痛评分（VAS）及不良反应.结果 2h时各组VAS评分均较低,差异无统计学意义；4、8、12、24h时F组、R组、FR组的VAS评分与N组相比均明显降低（均P＜0.05）,其中FR组与F组和R组相比,VAS评分又有明显降低（均P＜0.05）,而F组与R组差异无统计学意义.结论 关节腔内注射罗哌卡因复合芬太尼镇痛效果优于两者单独应用,而且并发症少,值得临床推广.Objective To observe the difference in analgesia effects of ropivacaine with fentanyl used intraarticularly after the single knee arthroscopy procedure.Methods 40 patients performed knee arthroscopy under combined spinal-epidural anaesthesia（ CSEA）,were randomly divided into 4 groups （n =10）,at the end of operation 10mlof different drug at the group F,R,FR and N（fentanyl 10μg,0.5% ropivacaine,fentanyl 10μg ＋0.5% ropivacaine,normal saline）were injected intra-articularly.The antalgic effects of four groups based on standard of VAS were observed at the 2,4,8,12 and 24h after operation.Results The 2h postoperative VAS scores were lower in four groups,the differences in four groups were not significant.The 4,8,12,24h postoperative VAS scores of F,R and FR group were much lower than that of N group （ all P 〈 0.05 ）.Moreover,VAS scores of FR group were much lower than that of F and R group（ all P 〈 0.05 ）.No other adverse effects were observed.Conclusion Intra-articular administration of ropivacaine with fentanyl could provide superior postoperative analgesia without side effects.It was an excellent regimen for analgesia after knee arthroscopy.

关 键 词：膝关节镜 罗哌卡因 芬太尼 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]