Kizilkaya Mehmet, Yildirim Omer Selim, Dogan Nazim, Kursad Husnu, Okur Ali
Departments of *Anesthesiology and Reanimation and †Orthopaedic Surgery, The School of Medicine, Ataturk University, Erzurum, Turkey.
Anesth Analg. 2004 Apr;98(4):1062-1065. doi: 10.1213/01.ANE.0000103185.18333.68.
We studied the effect of intraarticular saline, sufentanil, or sufentanil plus methylprednisolone after knee arthroscopic meniscectomy. In a double-blind randomized study, 60 patients undergoing knee arthroscopic meniscectomy were allocated to groups receiving intraarticular saline, intraarticular sufentanil 10 microg, or sufentanil 10 microg plus methylprednisolone 40 mg at the end of arthroscopy during general anesthesia. Postoperatively, pain levels at rest and during movement (i.e., active flexion of the knee) were measured by a visual analog scale and were significantly decreased in the sufentanil and sufentanil plus methylprednisolone groups compared with the control group. Moreover, we found that there was a significant reduction in intraarticular sufentanil and sufentanil plus methylprednisolone in the postoperative consumption of analgesics. We also found that the use of intraarticular sufentanil or sufentanil plus methylprednisolone after knee arthroscopic meniscectomy decreases the amount of supplementary analgesic needed for pain relief during the early postoperative period. In addition, we detected that sufentanil provided prolonged pain relief up to 24 h when compared with control, whereas when we combined sufentanil plus methylprednisolone, we found that it further reduced pain and use of analgesics when compared with sufentanil.
The combined use of intraarticular sufentanil (10 microg) and methylprednisolone (40 mg) in arthroscopic meniscectomy surgery reduced both postoperative pain scores and the use of additional analgesics.
我们研究了膝关节镜下半月板切除术后关节腔内注射生理盐水、舒芬太尼或舒芬太尼加甲泼尼龙的效果。在一项双盲随机研究中,60例行膝关节镜下半月板切除术的患者在全身麻醉下关节镜检查结束时被分为三组,分别接受关节腔内注射生理盐水、10微克关节腔内注射舒芬太尼或10微克舒芬太尼加40毫克甲泼尼龙。术后,通过视觉模拟评分法测量静息和活动时(即膝关节主动屈曲时)的疼痛程度,与对照组相比,舒芬太尼组和舒芬太尼加甲泼尼龙组的疼痛程度显著降低。此外,我们发现术后舒芬太尼组和舒芬太尼加甲泼尼龙组的镇痛药消耗量显著减少。我们还发现,膝关节镜下半月板切除术后使用关节腔内注射舒芬太尼或舒芬太尼加甲泼尼龙可减少术后早期缓解疼痛所需的补充镇痛药用量。此外,我们检测到与对照组相比,舒芬太尼可提供长达24小时的持久疼痛缓解,而当我们将舒芬太尼与甲泼尼龙联合使用时,发现与舒芬太尼相比,它可进一步减轻疼痛并减少镇痛药的使用。
在关节镜下半月板切除术中联合使用关节腔内注射舒芬太尼(10微克)和甲泼尼龙(40毫克)可降低术后疼痛评分并减少额外镇痛药的使用。