Dierking G W, Ostergaard H T, Dissing C K, Kristensen J E, Dahl J B
Department of Anaesthesiology, Silkeborg County Hospital, Denmark.
Anaesthesia. 1994 Jul;49(7):627-9. doi: 10.1111/j.1365-2044.1994.tb14236.x.
A study was performed to assess the analgesic effect of intra-articular morphine 2 mg in 33 patients undergoing elective arthroscopic meniscectomy. Patients were randomly allocated to receive either 2 mg of morphine hydrochloride in 40 ml of normal saline intra-articularly and 1 ml of normal saline intramuscularly (n = 18), or 40 ml of normal saline intra-articularly and 2 mg of morphine hydrochloride intramuscularly (n = 15). The latter group was to act as a control for any potential systemic effects of the morphine. All patients received an identical general anaesthesia consisting of propofol, alfentanil, enflurane and nitrous oxide/oxygen. No significant differences between the groups were found in pain scores at rest or during active flexion of the knee at 1-6 h postoperatively, or during walking at 6 h postoperatively (p > 0.05). Six and two patients in the intra-articular and intramuscular morphine group, respectively, requested supplemental morphine given intravenously (p > 0.05). In conclusion, no significant differences in pain scores or in requirements for supplemental morphine were observed between patients receiving intra-articular versus intramuscular morphine 2 mg after elective arthroscopic meniscectomy and consequently no specific local analgesic effect of intra-articular morphine could be demonstrated.
一项研究旨在评估2毫克关节内注射吗啡对33例行择期关节镜半月板切除术患者的镇痛效果。患者被随机分配，一组关节内注射40毫升生理盐水加2毫克盐酸吗啡，肌肉注射1毫升生理盐水（n = 18），另一组关节内注射40毫升生理盐水，肌肉注射2毫克盐酸吗啡（n = 15）。后一组作为吗啡任何潜在全身效应的对照。所有患者均接受相同的全身麻醉，包括丙泊酚、阿芬太尼、恩氟烷和氧化亚氮/氧气。术后1至6小时静息时、膝关节主动屈曲时或术后6小时行走时，两组间疼痛评分无显著差异（p > 0.05）。关节内注射吗啡组和肌肉注射吗啡组分别有6例和2例患者要求静脉补充吗啡（p > 0.05）。总之，择期关节镜半月板切除术后，接受关节内注射2毫克吗啡与肌肉注射2毫克吗啡的患者在疼痛评分或补充吗啡需求方面无显著差异，因此未显示关节内注射吗啡有特定的局部镇痛效果。
