小剂量羟考酮联合罗哌卡因关节腔内注射用于膝关节镜术后镇痛的效果  

Efficacy of intra-articular injection with low dose of oxycodone combined with ropivacaine for postoperative analgesia after arthroscopic knee surgery

作　　者：汪涛[1] 周巧林[1] 陶凤禹[1] 叶志虎[1] 刘秀[1] 严志勇[1] 

机构地区：[1]江苏省沭阳县人民医院麻醉科,223600

出　　处：《实用疼痛学杂志》2017年第6期446-449,共4页Pain Clinic Journal

基　　金：宿迁市2015年度市级指导性科技计划项目（项目编号：Z201513）

摘　　要：目的评价膝关节镜术后关节腔注射小剂量羟考酮联合罗哌卡因的镇痛效果。方法择期行关节镜诊治术患者120例，ASA分级Ⅰ或Ⅱ级，采用随机数字表法分为OR组、DR组、sR组（n=40）：手术结束时，分别关节腔注射羟考酮2ml（3mg）联合0．25％罗哌卡因18ml（OR组）、地塞米松2ml（5mg）联合0．25％罗哌卡因18ml（DR组）和生理盐水2ml联合0．25％罗哌卡因18ml（sR组）。于术后4、8、12、24、36h时分别观察静息VAS及运动VAS评分，记录术后镇痛药使用情况、不良反应及患者镇痛满意度。结果与SR组相比，OR组和DR组术后各时点静息VAS和运动VAS评分明显降低、Ramsav评分明显升高、术后镇痛药物使用率明显降低和患者镇痛满意度明显提升（P〈0．05）；与DR组相比，OR组术后各时点静息VAS和运动VAS评分及Ramsay评分明显降低、术后镇痛药物使用率明显降低和患者镇痛满意度明显提升（P〈0．05）；SR组恶心呕吐发生较多（P〈0．05），而OR组与DR组差异无统计学意义（P〉0．05）。结论小剂量羟考酮联合罗哌卡因关节腔内注射用于膝关节镜术后镇痛，镇痛效果确切、持久和患者满意度高且不良反应较少。Objective To evaluate the efficacy of intra-articular injection with low dose of oxyeodone combined with ropivacaine for postoperative analgesia after arthroscopic knee surgery. Methods One hundred and twenty patients scheduled for selective arthroscopic knee surgery under epidural anaesthesia, ASA Ⅰ or Ⅱ, were randomly divided into three groups using a random number table （n=40）. All patients received intra-articlular injection with 0.25 % ropivacaine 18 ml, in addition to oxycodone 2 ml （3 mg）, dexamethasone 2 ml （5 rag） and normal saline 2 ml in group OR, DR and SR respectively at the end of surgery. VAS at rest and during movement, and Ramsay scores were observed and recorded at 4, 8, 12, 24 and 36 h after surgery. The dosage of postoperative analgesics requirement, patient satisfaction degree with postoperative analgesia, and the incidence of side effects after surgery were recorded. Results Compared with group SR, VAS at rest and at active flexion of knee were significantly decreased, while Ramsay scores was significantly increased at each time points after surgery, the dosage of analgesics requirement was significantly fewer, and patient satisfaction degree for postoperative analgesia was significantly elevated after surgery in group OR and DR （P〈0.05）. Compared with group DR, VAS at rest and at active flexion of knee and Ramsay scores were significantly decreased, the dosage of degree analgesics requirement was significantly fewer, and patient satisfaction degree for postoperative analgesia was significantly elevated after surgery in group OR （P〈0.05）. The incidence of nausea and vomiting was relatively higher in group SR than that in the other groups （P〈0.05）, however, there was no significant difference in side effects between group OR and DR （P〉0.05）. Conclusion Intra-articular injection with low dose of oxycodone combined with ropivaeaine can provide effective analgesia, elevate patient satisfaction for postoperative analgesia after arthroscopic knee surgery, wi

关 键 词：羟考酮 酰胺类 注射 关节内 膝关节 关节镜 疼痛 手术后 镇痛 

分 类 号：R614[医药卫生—麻醉学]