氢吗啡酮复合罗哌卡因膝关节腔内注射对膝关节镜术后患者疼痛相关神经介质水平的影响  

Influence of hydromorphone combined with ropivacaine by knee intraarticular injection on pain related neurotransmitter level in patients after knee arthroscopy surgery

作　　者：范展[1] 张艳阁[2] Fan Zhan Zhang Yange(First-author＇s address Central Hospital of Nanyang, Nanyang 457003 , Henan, Chin)

机构地区：[1]南阳市中心医院,河南南阳473000 [2]濮阳市中医院,河南濮阳457003

出　　处：《临床心身疾病杂志》2017年第5期24-27,共4页Journal of Clinical Psychosomatic Diseases

摘　　要：目的 探讨氢吗啡酮复合罗哌卡因膝关节腔内注射对膝关节镜术后患者疼痛程度及血清疼痛相关神经介质水平的影响.方法 将90例行膝关节镜手术的膝关节病患者按随机数字表法分为两组,每组45例,两组均予以常规手术方式及围术期用药,观察组采用氢吗啡酮复合罗哌卡因注入关节腔进行术后镇痛,对照组采用罗哌卡因注入关节腔进行术后镇痛.比较两组术后不同时间的视觉模拟评分法评分、镇痛持续时间及围术期的血清疼痛相关神经介质表达水平检测结果.结果 观察组术后不同时间的视觉模拟评分法评分及镇痛持续时间均好于对照组（P〈0.05）,术后血清疼痛相关神经介质表达水平检测结果均显著低于对照组（P〈0.05）.结论 氢吗啡酮复合罗哌卡因膝关节腔内注射可有效改善膝关节镜术后患者疼痛程度,且对患者血清疼痛相关神经介质表达水平有积极的调控作用,值得在临床推广应用.Objective To investigate the influence of hydromorphone combined with ropivacaine by knee intraarticular injection on pain related neurotransmitter level in patients after knee arthroscopy surgery. Methods 90 patients with knee arthroscopic surgery in our hospital were selected as the research object and randomly divided into two groups, 45 cases in each group. They were all given routine operation and perioperative medication, observation group was given hydromorphone combined with ropivacaine by knee intraarticular injection for postoperative analgesia, control group was given ropivacaine by knee intraarticu- lar injection. Then the VAS score, duration of analgesia and expression levels of pain related mediators during the perioperative period of two groups were compared. Results The VAS score and analgesia du- ration of observation group at different time after the surgery were all better than those of control group （P〈0.05） ,the expression levels of pain related mediators after the surgery were all lower than those of control group （P〈0.05）. Conclusion The hydromorphone combined with ropivacaine by knee intraarticular injection can effectively improve the postoperative pain degree of patients with knee arthroscopic surgery,and it plays important role in the expression of pain related mediators, it is worthy of clinic promotion.

关 键 词：膝关节病 氢吗啡酮 罗哌卡因 膝关节腔内注射 膝关节镜手术 疼痛程度 神经介质 

分 类 号：R684[医药卫生—骨科学]