Lyons B, Lohan D, Flynn C G, Joshi G P, O'Brien T M, McCarroll M
Department of Anaesthesia, Cappagh Orthopaedic Hospital, Dublin, Ireland.
Br J Anaesth. 1995 Nov;75(5):552-5. doi: 10.1093/bja/75.5.552.
Intra-articular morphine has been shown to provide prolonged analgesia after arthroscopic knee surgery; the addition of local anaesthetic agents has been reported to improve this analgesic effect. Pethidine possesses local anaesthetic properties, and therefore this study was designed to evaluate its analgesic efficacy after arthroscopic meniscectomy. Sixty patients were allocated randomly to receive intra-articular injections of pethidine 50 mg, morphine 5 mg or saline after elective arthroscopic meniscectomy. Postoperative pain was assessed using an interval visual analogue scale and measuring analgesic requirements. Both treatment groups had significantly lower pain scores compared with the control group. Patients in the pethidine group had lower pain scores than those in the morphine group at 0.5, 1 and 2 h, but significantly higher scores at 12 and 24 h. These observations suggest that the local anaesthetic effect of pethidine may be responsible for the improved early analgesia, but its duration of action appears to be less than that of morphine.
关节内注射吗啡已被证明可在膝关节镜手术后提供长时间的镇痛效果；据报道，添加局部麻醉剂可改善这种镇痛效果。哌替啶具有局部麻醉特性，因此本研究旨在评估其在关节镜半月板切除术后的镇痛效果。60例患者在择期关节镜半月板切除术后被随机分配接受关节内注射50mg哌替啶、5mg吗啡或生理盐水。术后疼痛采用间隔视觉模拟量表进行评估，并测量镇痛需求。两个治疗组的疼痛评分均显著低于对照组。哌替啶组患者在0.5、1和2小时时的疼痛评分低于吗啡组，但在12和24小时时显著更高。这些观察结果表明，哌替啶的局部麻醉作用可能是早期镇痛改善的原因，但其作用持续时间似乎比吗啡短。
