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吗啡或布比卡因对膝关节镜检查患者术后疼痛的控制作用

Morphine or bupivacaine in controlling postoperative pain in patients subjected to knee joint arthroscopy.

作者信息

Grabowska-Gaweł A, Gaweł K, Hagner W, Biliński P J

机构信息

Katedra i Klinika Anestozjologii i Intensywnej Terapii AM, Bydgoszcz; Katedra i Zakład Kinezyterapii AM, Bydgoszcz; Katedra i Klinika Ortopedii i Traumatologii AM, Bydgoszcz.

出版信息

Ortop Traumatol Rehabil. 2003 Dec 30;5(6):758-62.

PMID:18034069
Abstract

Background. We investigated the efficacy of intra - articular bupivacaine with morphine administration after knee joint arthroscopy.
Material and methods. The present study compared intra- arthicular bupivacaine with intra-arthricular morphine for postoperative analgesia in 56 patients (21 women, 35 men) (age 20-70, mean 39.8) undergoing knee joint arthroscopy.
Intraoperatively, the patients received anaesthesia spinaly (0.5 % Marcaine spinal ASTRA) and immediately following surgery received 10 ml intra-arthricular injection consisting either of 0.5 % bupivacaine (group I), 5 mg morphine + 0.9 % saline (group II).Postoperative analgesia was supporeted by intravenous doses of proefferalgan.
In all patients the visual analogue pain score (VAS), PaO2, systolic blood preassure (SABP), diastolic blood preassure (DABP), heart rate (HR), respiratory rate (f), supplemented analgesia and possible side effects were monitored postoperatively.
Results. Intra-arthricular administration of each solution was well toleratede and non side effects were noted.
There was non significant difference among the two groups in monitored parameters. The mean time of postoperative analgesia was 185,7 +/- 25.3 min for bupivacaine group and 390.3 +/- 35,4 min for morphine group.
Total amount proefferalgan supplamentation was the highest in group I.
Conclusions. Postoperative intra- arthricular injections of bupivacaine and morphine for patients undergoing knee joint arthroscopy can provide a safe and effective analgesia and therefore shound be recommended and widely implamented into the clinical use as a standard procedure.

摘要

背景。我们研究了膝关节镜检查后关节腔内注射布比卡因联合吗啡的疗效。

材料与方法。本研究比较了关节腔内注射布比卡因与关节腔内注射吗啡对56例(21例女性,35例男性)(年龄20 - 70岁,平均39.8岁)接受膝关节镜检查患者的术后镇痛效果。

术中,患者接受脊髓麻醉(0.5%布比卡因重比重液,阿斯特拉公司生产),手术结束后立即接受10毫升关节腔内注射,注射药物为0.5%布比卡因(第一组)或5毫克吗啡 + 0.9%生理盐水(第二组)。术后镇痛通过静脉注射非甾体抗炎药来辅助。

所有患者术后均监测视觉模拟疼痛评分(VAS)、动脉血氧分压(PaO₂)、收缩压(SABP)、舒张压(DABP)、心率(HR)、呼吸频率(f)、辅助镇痛情况及可能的副作用。

结果。关节腔内注射每种溶液耐受性良好,未观察到副作用。

两组监测参数之间无显著差异。布比卡因组术后镇痛平均时间为185.7 ± 25.3分钟,吗啡组为390.3 ± 35.4分钟。

第一组非甾体抗炎药的总补充量最高。

结论。膝关节镜检查患者术后关节腔内注射布比卡因和吗啡可提供安全有效的镇痛效果,因此应作为标准程序推荐并广泛应用于临床。

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