Rokhtabnak Faranak, Ale Bouyeh Mahmood Reza, Seyed Siamdust Alireza, Masoomshahi Mehdi, Aghajani Marjan
Firouzgar Hospital, Anesthesiology Group, Medical Faculty, Iran University of Medical Sciences, Tehran, Iran.
Rasul Akram Hospital, Anesthesiology Group, Medical Faculty, Iran University of Medical Sciences, Tehran, Iran.
Br J Pain. 2015 Aug;9(3):149-56. doi: 10.1177/2049463714553312.
INTRODUCTION: Effective pain relief is important after arthroscopic knee surgery to permit initiation of daily activities of life. This study is performed in order to investigate the effect of multi-model therapy for pain control after surgery. This clinical, randomized and double-blind trial is conducted on patients who get knee arthroscopy surgery. METHODS: Of these patients, 40 were divided into two groups by Block Randomization method: 1 - sole ropivacaine group (150 mg); 2 - combined ketorolac (30 mg); and ropivacain (150 mg) group. These drugs were injected intra-articularly at the end of knee arthroscopic surgery. The first consequence including measurement of pain severity after entrance to recovery room and 2, 4, 8, 12, 18 and 24 hours after surgery were evaluated according to the visual analogue pain score. The second consequence, including nausea, vomiting and sedation, was assessed by expert nurses in the recovery room and surgery part according to nausea and vomiting scale and Ramsay sedation scale, respectively. RESULTS: All groups had excellent analgesia at 0 and 4 hours, postoperatively. Group-combined ketorolac and ropivacaine had significantly lower visual analogue pain score as well as higher sedative scale at 8, 12, 18 and 24 hours after surgery at rest and during movement compared with the other group (p < 0.05). Moreover, there was no statistical difference between groups in regard of nausea and vomiting. CONCLUSION: Addition of ketolorac to ropivacaine intra-articularly in arthroscopic knee surgery enhances analgesic efficacy of local anaesthetics and cause more sedation after surgery.
引言:膝关节镜手术后有效的疼痛缓解对于开始日常生活活动很重要。本研究旨在调查多模式疗法对术后疼痛控制的效果。这项临床随机双盲试验是针对接受膝关节镜手术的患者进行的。 方法:在这些患者中,通过区组随机化方法将40例患者分为两组:1-单纯罗哌卡因组(150mg);2-酮咯酸(30mg)与罗哌卡因(150mg)联合组。这些药物在膝关节镜手术结束时关节腔内注射。根据视觉模拟疼痛评分评估第一个结果,包括进入恢复室时以及术后2、4、8、12、18和24小时的疼痛严重程度测量。第二个结果,包括恶心、呕吐和镇静,分别由恢复室和手术科室的专业护士根据恶心呕吐量表和拉姆齐镇静量表进行评估。 结果:所有组在术后0和4小时均有良好的镇痛效果。与另一组相比,酮咯酸与罗哌卡因联合组在术后8、12、18和24小时休息和活动时的视觉模拟疼痛评分显著更低,镇静评分更高(p<0.05)。此外,两组在恶心和呕吐方面无统计学差异。 结论:在膝关节镜手术中关节腔内将酮咯酸添加到罗哌卡因中可提高局部麻醉药的镇痛效果,并导致术后更多的镇静作用。
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