Salman Nevriye, Olgunkeleş Bilge, Bektaş Umut, Güner Derviş, Bektas Meltem, Ay Şadan, Şekerci Sumru
Saglik Bilimleri Universitesi, Yuksek Ihtisas Ankara Training and Education Hospital, Department of Anesthesiology and Reanimation, Ankara, Turquia.
Ankara Beytepe Murat Erdi Eker Hospital, Department of Anesthesiology and Reanimation, Ankara, Turquia.
Braz J Anesthesiol. 2019 Jan-Feb;69(1):35-41. doi: 10.1016/j.bjan.2018.09.003. Epub 2018 Nov 6.
Postoperative pain control is important in terms of early recovery and rehabilitation in arthroscopic meniscectomy. For this purpose, we aimed to compare the effects of intraarticular tramadol, magnesium, and ketamine with combinations of pericapsular bupivacaine on postoperative pain and recovery in arthroscopic meniscectomy.
Ninety patients who underwent arthroscopic meniscectomy were enrolled in the study. Group T was given tramadol, Group K was given ketamine, and Group M was given magnesium reconstituted intraarticularly, and all groups received periarticular bupivacaine. Comparisons were made in terms of the patients’ postoperative Visual Analogue Scale scores with and without movement, need for additional analgesics, first analgesic time, mobilization times, adverse effects, and satisfaction with the analgesics.
The Visual Analogue Scale scores were lowest in Group T at 0 minutes, and were higher in the 15th and 30th minutes and 1st, 2nd, and 6th hours. Visual Analogue Scale values with movement were found to be high in Group M at 0 and 15 minutes, but they were found to be higher in group T in the 30th minute, 1st, 2nd and 6th hour. The groups were similar in terms of postoperative additional analgesic use, number of analgesic use, and satisfaction with analgesics; however, the first analgesic time was earlier in Group M, and the first mobilization time was earlier in Group K.
Intraarticular ketamine enables early mobilization and less need for additional analgesics, it also provides a better analgesic effect in comparison with intraarticular tramadol and magnesium.
在关节镜半月板切除术的早期恢复和康复方面，术后疼痛控制至关重要。为此，我们旨在比较关节腔内注射曲马多、镁和氯胺酮与关节周围注射布比卡因联合使用对关节镜半月板切除术后疼痛和恢复的影响。
90例行关节镜半月板切除术的患者纳入本研究。T组给予曲马多，K组给予氯胺酮，M组给予关节腔内注射镁，所有组均接受关节周围注射布比卡因。比较患者术后有无活动时的视觉模拟量表评分、额外镇痛药物的需求、首次镇痛时间、活动时间、不良反应以及对镇痛药物的满意度。
T组在0分钟时视觉模拟量表评分最低，在第15、30分钟以及第1、2和6小时时评分较高。M组在0和15分钟时有活动时的视觉模拟量表值较高，但在第30分钟、第1、2和6小时时T组的评分更高。各组在术后额外使用镇痛药物、镇痛药物使用次数以及对镇痛药物的满意度方面相似；然而，M组的首次镇痛时间更早，K组的首次活动时间更早。
关节腔内注射氯胺酮可实现早期活动且减少对额外镇痛药物的需求，与关节腔内注射曲马多和镁相比，它还具有更好的镇痛效果。
