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椎管麻醉下切开复位内固定术中外周与关节内注射吗啡-氯胺酮复方的镇痛效果比较。

Comparison of the analgesic effect of intra-articular and extra-articular injection of morphine and ketamine compound in arthrotomy lower limb surgery under spinal anesthesia.

机构信息

Reza Akhondzade, Assistant Professor, Department of Anesthesiology, Ahvaz Jundishapur University of Medical Science, Pain Research Center, Ahvaz, Iran.

Mohammad Reza Pipelzade, Associate Professor, Department of Anesthesiology, Ahvaz Jundishapur University of Medical Science, Pain Research Center, Ahvaz, Iran.

出版信息

Pak J Med Sci. 2014 Sep;30(5):942-5. doi: 10.12669/pjms.305.4775.

DOI:10.12669/pjms.305.4775
PMID:25225503
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4163208/
Abstract

OBJECTIVE

One of the critical components in the postoperative care is pain. Given that little research has been done regarding the analgesic effects of intra-articular injection of ketamine, this study was aimed to compare the analgesic effect of intra-articular and extra-articular injection of morphine and ketamine compound in arthrotomy surgery under spinal anesthesia.

METHODS

A total of 50 patients were candidate for arthrotomy surgery, aged 18-60 years were divided randomly into two groups. At the end of surgery, the first group was treated with combination of intra-articular morphine and ketamine compound and the second group was treated with combination of extra-articular morphine and ketamine compound. The amount of postoperative pain was recorded in the hours of 2,4,6,12,24 respectively. Also 24 hours consumption of rescue analgesic was recorded.

RESULTS

The pain severity (VAS) in the hours of 2, 4, 6, 12 and 24 after surgery in the intra-articular injection group was significantly lower than the extra-articular injection group (P<0.05). Postoperative morphine consumption in intra-articular injection group (3.2±3.78) was significantly less than the extra-articular injection group (6.36±5.22) (p = 0.018).

CONCLUSION

Postoperative pain severity of intra-articular injection of ketamine and morphine in knee surgery is less than extra-articular injection.

摘要

目的

术后护理的一个关键组成部分是疼痛。鉴于关于关节内注射氯胺酮的镇痛效果的研究很少，本研究旨在比较关节内和关节外注射吗啡和氯胺酮复方在椎管内麻醉下关节切开术后的镇痛效果。

方法

共有 50 名患者适合行关节切开术，年龄在 18-60 岁之间，随机分为两组。手术结束时，第一组接受关节内吗啡和氯胺酮复方治疗，第二组接受关节外吗啡和氯胺酮复方治疗。分别在术后 2、4、6、12、24 小时记录术后疼痛程度。还记录了 24 小时内抢救性镇痛药的消耗。

结果

术后 2、4、6、12 和 24 小时，关节内注射组的疼痛严重程度（VAS）明显低于关节外注射组（P<0.05）。关节内注射组术后吗啡消耗量（3.2±3.78）明显少于关节外注射组（6.36±5.22）（p = 0.018）。

结论

膝关节手术中关节内注射氯胺酮和吗啡的术后疼痛程度低于关节外注射。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf1/4163208/754364f24d82/pjms-30-0942-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf1/4163208/754364f24d82/pjms-30-0942-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf1/4163208/754364f24d82/pjms-30-0942-g001.jpg

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