Reuben S S, Connelly N R
Department of Anesthesiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts 01199, USA.
Anesth Analg. 1996 May;82(5):1036-9. doi: 10.1097/00000539-199605000-00027.
Both ketorolac, a nonsteroidal antiinflammatory drug, and morphine, an opioid agonist, provide enhanced patient analgesia after arthroscopic knee surgery when administered via the intraarticular route. This study was designed to determine whether ketorolac or morphine results in better patient analgesia and whether their combination would provide superior analgesia to either drug alone. Patients undergoing arthroscopic knee meniscus repair under local anesthesia with sedation were evaluated. Each of the study groups evaluated received ketorolac (either via the parenteral or intraarticular route) and morphine (via either the parenteral or intraarticular route). This study revealed a significant benefit from the individual intraarticular administration of both morphine and ketorolac. The combination of these drugs did not result in decreased postoperative pain or need for postoperative analgesics, and it did not result in an increased analgesic duration. We conclude that the use of either intraarticular ketorolac or intraarticular morphine improves the comfort in patients undergoing arthroscopic meniscus repair and that their combination offers no advantage over either drug alone.
非甾体抗炎药酮咯酸和阿片类激动剂吗啡经关节内途径给药时，均可增强膝关节镜手术后患者的镇痛效果。本研究旨在确定酮咯酸或吗啡是否能带来更好的患者镇痛效果，以及它们的联合使用是否比单独使用任何一种药物能提供更优的镇痛效果。对在局部麻醉加镇静下接受膝关节半月板修复术的患者进行了评估。每个研究组均接受了酮咯酸（经胃肠外或关节内途径）和吗啡（经胃肠外或关节内途径）。本研究表明，单独关节内注射吗啡和酮咯酸均有显著益处。这些药物的联合使用并未导致术后疼痛减轻或术后镇痛药需求减少，也未导致镇痛持续时间延长。我们得出结论，关节内使用酮咯酸或关节内使用吗啡均可改善接受半月板修复术患者的舒适度，且它们的联合使用并不比单独使用任何一种药物更具优势。
