关节镜术后关节腔内注入利多卡因和局部冰敷镇痛的临床观察  

Clinical observation of arthroscopy postoperative intra-articular injection of lidocaine and local ice analgesia

作　　者：杨爱荣 江中太 娄宏亮 

机构地区：[1]河北省涉县肿瘤医院外科,河北涉县056404 [2]峰峰矿务局医院骨三科,河北邯郸056200

出　　处：《中国现代医生》2013年第6期21-22,25,共3页China Modern Doctor

摘　　要：目的观察利多卡因关节内注射和局部冰敷对膝关节镜手术后的镇痛效果。方法选择ASAⅠ～Ⅱ级择期腰硬联合麻醉下行单侧膝关节镜手术的患者69例,随机分为三组(A组、B组和C组),每组23例。A组关节镜术后关节腔内注射5 mL利多卡因但不予冰敷;B组关节镜术后关节内注射5 mL生理盐水并予以局部冰敷24 h;C组关节镜术后关节内注射5 mL利多卡因并予以局部冰敷24 h。术后行视觉模拟评分(VAS),观察三组患者膝关节镜手术后的镇痛效果。结果术后1～8 h A组的VAS评分显著低于B组,差异有统计学意义(P<0.05),但8 h之后差异无统计学意义(P>0.05)。术后1 h VAS评分A组明显低于C组,差异有统计学意义(P<0.05),1 h后的VAS评分A组和C组差异均无统计学意义(P>0.05)。术后1 h VAS评分B组和C组差异无统计学意义(P>0.05),4 h和8 h VAS评分C组高于B组,差异有统计学意义(P<0.05),但8 h之后差异无统计学意义(P>0.05)。结论关节内注射利多卡因和局部冰敷单独使用均可以有效缓解膝关节镜手术后的疼痛,但关节内注射利多卡因联合局部冰敷的镇痛效果无明显协同作用,在术后1 h内局部冰敷可以减弱关节内注射利多卡因的镇痛效果。Objective To evaluate the analgesic effect of intra-articular lidocaine and local ice compress after knee arthroscopy. Methods Sixty-nine patients receiving selective arthroscopy under spinal combined with epidural anesthesia were randomized into three groups of 23 patients. The patients in group A were received intra-artieular 5 mL lidoeaine injection after the operation;in group B received intra-articular equal normal saline injection combined with ice compress after the operation;in group C received intra-articular equal lidoeaine injection combined with ice compress after the operation.The VAS and adverse effects were recorded. Results VAS in group A was significantly lower than that in group B during 1-8 hours after the operation（P 〈 0.05） ;but there was no significant difference after 8 hours. There was a significant ＇decrease of VAS at 1 h （P 〈 0.05） between group A and group C, no significant ! difference was found between tow groups after 1 h （P 〉 0.05）. VAS in group C was more than that in group B,no significant difference was found between tow groups at 1 h and after 8 h （P 〉 0.05）. Conclusion Lidocaine intra- articular injection and local ice compress after knee arthroscopy can relieve the pain after the operation; but there was no synergetic effect of lidocaine intra-articular injection combined with ice compress after knee arthroscopy ini relieveing the pain, which can decrease the analgesic effect of lidocaine intra-artieular injection.

关 键 词：利多卡因 关节镜 局部冰敷 镇痛 关节腔内注射 

分 类 号：R614.3[医药卫生—麻醉学]