McGuire D A, Sanders K, Hendricks S D
Knee and Arthroscopic Surgery, Anchorage, Alaska.
Arthroscopy. 1993;9(6):653-61. doi: 10.1016/s0749-8063(05)80501-8.
Pain control is an important postoperative consideration with any surgical procedure. Technological and procedural improvements have contributed to the reduction in both the degree of surgical difficulty and the postsurgical complications associated with intricate surgeries. As a result, certain surgeries have potential for being performed on an outpatient basis, dependent upon appropriate pain-management regimens and the degree of potential for postoperative complications. Arthroscopic anterior cruciate ligament (ACL) reconstruction is a common procedure. Because of the reduction in invasiveness that arthroscopy provides, outpatient surgery is now routinely employed for ACL patients. The arguments against ACL outpatient surgery have included the reluctance to use ambulatory, indwelling, intravenous pain-pump delivery systems for opioid pain medication. The purpose of this study was to determine the efficacy of a ketorolac tromethamine used for the management of the postoperative pain produced as a result of outpatient ACL reconstruction. When the ketorolac pain management regimen is compared in this setting with meperidine or morphine, pain control is as good as, or in some cases better than, either of the opioid drugs. Additionally, the adverse side effects associated with opioid drugs are significantly reduced at a substantially lower direct cost to the patient.
疼痛控制是任何外科手术术后都要重点考虑的问题。技术和操作上的改进有助于降低手术难度以及与复杂手术相关的术后并发症。因此,某些手术在有适当的疼痛管理方案和术后并发症潜在风险程度的情况下,有可能在门诊进行。关节镜下前交叉韧带(ACL)重建是一种常见的手术。由于关节镜手术的侵入性降低,门诊手术现在已常规用于ACL患者。反对ACL门诊手术的理由包括不愿使用用于阿片类止痛药的可移动、留置式静脉止痛泵给药系统。本研究的目的是确定用于门诊ACL重建术后疼痛管理的酮咯酸氨丁三醇的疗效。在此情况下,将酮咯酸疼痛管理方案与哌替啶或吗啡进行比较时,疼痛控制效果与阿片类药物相当,在某些情况下甚至更好。此外,与阿片类药物相关的不良副作用显著减少,且患者直接成本大幅降低。