Segelman Jerker, Pettersson Hans Järnbert, Svensén Christer, Divander Mona-Britt, Barenius Björn, Segelman Josefin
Section of Anaesthesiology and Intensive Care, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, 118 81, Stockholm, Sweden.
Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
J Anesth. 2016 Oct;30(5):803-10. doi: 10.1007/s00540-016-2209-y. Epub 2016 Jul 1.
Glucocorticoids are reported to improve postoperative analgesia. The purpose of the study was to investigate whether a preoperative, single dose of betamethasone could reduce pain after ambulatory arthroscopic knee surgery.
This was a randomized, double-blind, placebo-controlled trial including patients scheduled for knee arthroscopy. The intervention was an intravenous injection of betamethasone 8 mg or placebo. The primary outcome was pain day 1 evaluated by a verbal descriptor scale (VDS).
In total, 74 patients (betamethasone = 34; placebo = 40) were randomized. One patient in each group was excluded from analysis. During activity day 1 following surgery, the proportion with no or minor pain was significantly (p = 0.030) higher in the betamethasone group (22 of 33; 67 %) compared with the placebo group (17 of 39; 44 %). At rest, the corresponding figures were 26 of 33 (79 %) for betamethasone and 24 of 39 (62 %) for placebo (p = 0.062). After 3 months of follow-up, no patient receiving betamethasone experienced adverse events while six receiving placebo did (postoperative nausea and vomiting in five and delayed wound healing in one).
An analgesic benefit was seen day 1 following surgery. This indicates that betamethasone has a place in ambulatory arthroscopic knee surgery.
https://www.clinicaltrialsregister.eu/ (identifier 2009-014717-27).
据报道，糖皮质激素可改善术后镇痛效果。本研究旨在调查术前单次注射倍他米松是否能减轻门诊膝关节镜手术后的疼痛。
这是一项随机、双盲、安慰剂对照试验，纳入计划接受膝关节镜检查的患者。干预措施为静脉注射8毫克倍他米松或安慰剂。主要结局指标为术后第1天采用语言描述量表（VDS）评估的疼痛情况。
总共74例患者（倍他米松组 = 34例；安慰剂组 = 40例）被随机分组。每组各有1例患者被排除在分析之外。术后第1天活动期间，倍他米松组（33例中的22例；67%）无疼痛或轻微疼痛的比例显著高于安慰剂组（39例中的17例；44%）（p = 0.030）。休息时，倍他米松组相应数字为33例中的26例（79%），安慰剂组为39例中的24例（62%）（p = 0.062）。随访3个月后，接受倍他米松治疗的患者均未出现不良事件，而接受安慰剂治疗的有6例出现不良事件（5例术后恶心呕吐，1例伤口愈合延迟）。
术后第1天观察到镇痛效果。这表明倍他米松在门诊膝关节镜手术中有一定作用。
https://www.clinicaltrialsregister.eu/（标识符2009 - 014717 - 27）
