Boden B P, Fassler S, Cooper S, Marchetto P A, Moyer R A
Department of Orthopedic Surgery, Temple University Hospital, Philadelphia, PA 19140.
Arthroscopy. 1994 Feb;10(1):104-7. doi: 10.1016/s0749-8063(05)80301-9.
In a double-blind randomized fashion, 38 patients were divided into four groups according to the intraarticular injection received after arthroscopic surgery. Patients in group I (n = 7) received saline, group II (n = 10) morphine, group III bupivacaine, and group IV (n = 11) morphine and bupivacaine. Before surgery and at 0.5, 1, 1.5, 2, 6, and 24 h postoperatively, pain levels were recorded. In addition, postoperative supplemental i.v. morphine requested by the patient was tabulated. Results showed that the mean consumption of supplemental analgesia was lowest in the morphine/bupivacaine group. Although there was a statistically significant difference in pain scores between the saline group and the other three groups during the early postoperative period, there was no significant difference in pain scores between the morphine, bupivacaine, and morphine/bupivacaine groups. We conclude that postoperative, intraarticular injection of analgesics is beneficial in reducing pain levels. The combination of morphine/bupivacaine appears to be the most beneficial analgesic due to its low supplemental analgesic requirements postoperatively.
采用双盲随机方式，38例患者在关节镜手术后根据接受的关节内注射被分为四组。第一组（n = 7）患者接受生理盐水注射，第二组（n = 10）接受吗啡注射，第三组接受布比卡因注射，第四组（n = 11）接受吗啡和布比卡因注射。在手术前以及术后0.5、1、1.5、2、6和24小时记录疼痛程度。此外，将患者术后要求追加的静脉注射吗啡用量制成表格。结果显示，吗啡/布比卡因组的补充镇痛平均用量最低。虽然术后早期生理盐水组与其他三组之间的疼痛评分存在统计学显著差异，但吗啡组、布比卡因组和吗啡/布比卡因组之间的疼痛评分无显著差异。我们得出结论，术后关节内注射镇痛药有助于降低疼痛程度。吗啡/布比卡因联合使用似乎是最有益的镇痛药，因为其术后补充镇痛需求较低。
