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关节腔内注射右美托咪定对膝关节镜手术后疼痛的影响。

Effect of Intra-articular Dexmedetomidine on Postoperative Pain after Knee Arthroscopic Surgery.

作者信息

Nesioonpour Sholeh, Mohtadi Ahmad Reza, Ghomeishi Ali, Savaie Mohsen, Pedram Hooman, Poursalehan Sara, Esfahanian Yasaman

机构信息

Department of Anesthesiology,Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Department of Orthopedic Surgery, Shohadaye Naft Hospital, Susangerd, Iran.

出版信息

Arch Bone Jt Surg. 2022 Mar;10(3):272-277. doi: 10.22038/ABJS.2021.53942.2706.

Abstract

BACKGROUND

This study aimed to prevent and control the pain after arthroscopy that leads to patient satisfaction, rehabilitation, and return to normal life as soon as possible. It is hypothesized that there is no difference between intra-articular injection of dexmedetomidine and placebo after knee arthroscopy regarding pain level.

METHODS

This double-blind randomized clinical trial was conducted on 70 patients aged 18-60 years who were candidates for elective knee arthroscopic surgery with the American Society of Anesthesiologists Classification I-II. All patients underwent spinal anesthesia equally and were randomly divided into two groups of 35 cases per group. The drug group (D) received 2 μg/kg dexmedetomidine with 0.9% normal saline reached to a volume of 20 ml, and 20 ml of 0.9% normal saline was injected into the knee joint through the cannular sheath in the control group (C). Postoperative pain intensity was recorded 1, 2, 4, 8, 16, 24 h after injection using the Visual Analogue Scale. The time of requesting the first analgesic and the amount of analgesics consumed were recorded after 24 h.

RESULTS

There was no significant difference between the two groups in terms of age, height, weight, duration of spinal anesthesia, and duration of surgery (). In group D, there was a decrease in postoperative pain, a decrease in the amount of analgesic consumed, and an increase in the time of the first analgesic request, compared to group C ().

CONCLUSION

This study showed that intra-articular injection of dexmedetomidine relieved postoperative pain, reduced analgesic consumption, and increased the time of first analgesic request after knee arthroscopy.

摘要

背景

本研究旨在预防和控制关节镜检查后的疼痛,以提高患者满意度,促进康复,并使其尽快恢复正常生活。假设膝关节镜检查后关节内注射右美托咪定与安慰剂在疼痛程度上无差异。

方法

本双盲随机临床试验纳入了70例年龄在18 - 60岁之间、拟行择期膝关节镜手术且美国麻醉医师协会分级为I - II级的患者。所有患者均接受相同的脊髓麻醉,并随机分为两组,每组35例。药物组(D组)接受2μg/kg右美托咪定加0.9%生理盐水至20ml,对照组(C组)通过套管鞘向膝关节内注射20ml 0.9%生理盐水。使用视觉模拟量表在注射后1、2、4、8、16、24小时记录术后疼痛强度。24小时后记录首次要求使用镇痛药的时间和镇痛药的消耗量。

结果

两组在年龄、身高、体重、脊髓麻醉持续时间和手术持续时间方面无显著差异()。与C组相比,D组术后疼痛减轻,镇痛药消耗量减少,首次要求使用镇痛药的时间延长()。

结论

本研究表明,膝关节镜检查后关节内注射右美托咪定可减轻术后疼痛,减少镇痛药消耗,并延长首次要求使用镇痛药的时间。

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Postoperative pain control.术后疼痛控制
Surg Clin North Am. 2015 Apr;95(2):301-18. doi: 10.1016/j.suc.2014.10.002. Epub 2015 Jan 24.

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