舒芬太尼联合罗哌卡因关节腔内注射用于膝关节镜术后镇痛的临床研究  

Clinical Research on Intra-articular Injection of Sufentanil and Ropivacaine for Analgesia after Arthroscopic Knee Surgery

作　　者：秦丹[1] 刘永芳[1] 张力[1] 丰新民[1] 

机构地区：[1]武汉市第一医院麻醉科,武汉430022

出　　处：《中国中医骨伤科杂志》2012年第10期40-42,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:观察、评价膝关节镜术后关节腔内注射舒芬太尼联合罗哌卡因的镇痛效果及其安全性,并初步探讨其作用机制。方法:择期腰麻下行膝关节镜下半月板切除手术病人90例,ASAⅠ～Ⅱ级,随机分为3组(n=30):生理盐水组(S组)、罗哌卡因组(R组)、罗哌卡因加舒芬太尼组(RS组)。手术结束时分别向关节腔内注射生理盐水20mL(S组),0.45%罗哌卡因20mL(R组),0.45%罗哌卡因与10μg舒芬太尼混合液20mL(RS组)。记录术前、术后的VAS评分以及额外镇痛剂的需要量,观察不良反应。结果:与S组比较,在安静和运动状态下,R组和RS组的VAS评分和额外镇痛剂的需要量均显著降低(P<0.05);与R组比较,在运动状态下,RS组的VAS评分和额外镇痛剂的需要量均显著降低(P<0.05);各组均未发现不良反应。结论:膝关节镜术后舒芬太尼联合罗哌卡因关节腔内注射能够增强术后镇痛效果,减少额外镇痛剂的需要量。Objective：To observe and evaluate the analgesic effects and security of intra-articular injection of sufentanil and ropivacaine after arthroscopic knee surgery.Methods：All 90 patients undergoing scheduled arthroscopic knee surgery under subarachnoid anesthesia,ASAⅠ~Ⅱ,were randomly divided into 3 groups： physiological saline group（Group S）,ropivacaine group（Group R）,and sufentanil plus ropivacaine group（Group RS）.After surgery,Group S received 20 ml physiological saline intra-articularly,Group R received 0.45% ropivacaine 20ml intra-articularly,and Group RS received sufentanil 10 μg plus 0.45% ropvacaine in 20 ml mixed solution intra-articularly.We recorded the Visual Analog Scale（VAS） score and the demand of additional analgesic of each patient before and after surgery,and observed the side effects.Results：Compared with Group S,VAS score and the demand of additional analgesic in Group R and Group RS both statistically decreased（P0.05） during resting and moving state.Compared with Group R,VAS score and the demand of additional analgesic in Group RS statistically decreased（P0.05） during moving state.No side effect was found in each group.Conclusion：The combined use of sufentanil and ropivacaine intra-articularly after arthroscopic knee surgery can strengthen the analgesic effect and reduce the demand of additional analgesic.

关 键 词：舒芬太尼 罗哌卡因 关节腔内 膝关节镜 术后镇痛 

分 类 号：R614.27[医药卫生—麻醉学]