Jazayeri Seyed Mohammad, Mosaffa Faramarz, Abbasian Mohammadreza, Hosseinzadeh Hamid Reza
Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2012 Summer;2(1):28-31. doi: 10.5812/aapm.4815. Epub 2012 Jul 10.
Intra-articular analgesia is a pain reliever that is frequently administered following arthroscopic knee surgery.
The purpose of this study was to compare the efficacy of intra-articular application of morphine and tramadol on postoperative pain after arthroscopic knee surgery.
For this randomized double blinded clinical trial, 132 patients undergoing minor arthroscopic knee surgery were randomly assigned to receive either; 5 mg morphine or 50 mg tramadol intra-articularly. Pain was evaluated by means of the verbal pain rating score (VRS) preoperatively (at rest and on movement of the knee joint) and postoperatively at 0, 1, 2, 3, 4, 6, 12 and 24 hours. Meanwhile, the time of the first analgesic request and need for supplemental analgesic were also recorded.
There was no statistically significant difference in VRS scoring between the two groups during the preoperative period either at rest or on knee movement. Meanwhile, VRS scores did not differ significantly between the morphine and tramadol treated groups postoperatively, except for in the one-hour post-operative scores in which the tramadol-treated group experienced less pain (P < 0.007). Post-operative VRS scores at 6, 12, and 24 hours were significantly decreased when compared with previous scores in both morphine and tramadol prescribed subjects (P < 0.001), hence, both local analgesics can significantly reduce pain after minor knee surgery.
We have found a postoperative analgesic effect of intra-articularly administered morphine and tramadol following minor arthroscopic knee surgeries with a maximum effect 6 hours post injection.
关节内镇痛是一种常用于膝关节镜手术后的止痛方法。
本研究旨在比较关节内注射吗啡和曲马多对膝关节镜手术后疼痛的缓解效果。
在这项随机双盲临床试验中，132例行小型膝关节镜手术的患者被随机分为两组，分别关节内注射5毫克吗啡或50毫克曲马多。术前（休息时及膝关节活动时）及术后0、1、2、3、4、6、12和24小时通过语言疼痛评分量表（VRS）评估疼痛程度。同时，记录首次要求使用镇痛剂的时间及追加镇痛剂的需求情况。
术前休息及膝关节活动时，两组VRS评分无统计学显著差异。术后，除术后1小时曲马多治疗组疼痛较轻（P < 0.007）外，吗啡组与曲马多组VRS评分无显著差异。与之前评分相比，吗啡组和曲马多组术后6、12及24小时的VRS评分均显著降低（P < 0.001），因此，两种局部镇痛药均可显著减轻小型膝关节镜手术后的疼痛。
我们发现，小型膝关节镜手术后关节内注射吗啡和曲马多均有术后镇痛效果，注射后6小时镇痛效果最佳。
