Paul S, Bhattacharjee D P, Ghosh S, Dawn S, Chatterjee N
Department of Pharmacology, National Medical College, Kolkata, India.
Ceylon Med J. 2010 Dec;55(4):111-5. doi: 10.4038/cmj.v55i4.2627.
Various drugs are administered intraarticularly to provide postoperative analgesia after arthroscopic knee surgery, of which opioids and alpha2 agonists could be of particular interest.
Sixty patients undergoing elective knee arthroscopy were randomly assigned to two groups (n = 30). Group R received 19 ml of 0.25% ropivacaine and 1 ml of isotonic saline (total volume 20 ml) intraarticularly. Group RD received 100 microg (1 ml) of dexmedetomidine added to 19 ml of 0.25% ropivacaine intra-articularly (total volume 20 ml). Analgesic effect was evaluated by measuring pain intensity (VAS score) and duration of analgesia.
A longer delay was observed between intraarticular injection of study medication and first requirement of supplementary analgesic in group RD (10.84 +/- 2.6 hours) compared to group R (5.38 +/- 1.4 hours). Total consumption of fentanyl citrate in postoperative period was significantly less in group RD. No significant side effects were noted.
Dexmedetomidine, added as adjunct to ropivacaine in patients undergoing arthroscopic knee surgery, improve the quality and duration of postoperative analgesia.
关节镜下膝关节手术后，多种药物通过关节内给药来提供术后镇痛，其中阿片类药物和α2激动剂可能特别值得关注。
60例行择期膝关节镜检查的患者被随机分为两组（每组n = 30）。R组关节内注射19 ml 0.25%罗哌卡因和1 ml等渗盐水（总体积20 ml）。RD组关节内注射加入100 μg（1 ml）右美托咪定的19 ml 0.25%罗哌卡因（总体积20 ml）。通过测量疼痛强度（视觉模拟评分法[VAS]评分）和镇痛持续时间来评估镇痛效果。
与R组（5.38±1.4小时）相比，RD组关节内注射研究药物至首次需要补充镇痛剂的间隔时间更长（10.84±2.6小时）。RD组术后枸橼酸芬太尼的总消耗量显著更少。未观察到明显的副作用。
在接受关节镜下膝关节手术的患者中，右美托咪定作为罗哌卡因的辅助用药，可提高术后镇痛的质量和持续时间。
