Williams J S, Wexler G, Novak P J, Bush-Joseph C A, Bach B R, Badrinath S K
Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Westlake, Ohio 44145, USA.
Arthroscopy. 1998 Sep;14(6):613-6. doi: 10.1016/s0749-8063(98)70058-1.
A prospective study was undertaken to evaluate the postoperative pain and analgesic profiles of a group of 50 patients undergoing outpatient anterior cruciate ligament (ACL) reconstruction and to compare their profiles with those of a group of 50 patients undergoing outpatient non-ACL arthroscopic surgery. All patients received preoperative and postoperative ketorolac, intraincisional/intra-articular bupivacaine, intraoperative ketorolac, and propofol anesthetic. The percentage of patients receiving supplemental analgesia in the recovery room was 49% (average, 2.2 mg intravenous morphine sulfate) for the ACL group and 31% (average, 1.2 mg intravenous morphine sulfate) in the non-ACL group. Narcotic use and pain scores peaked in both groups on postoperative days 1 and 2. The ACL group used significantly more narcotic and had higher pain scores in the first week after surgery than did the non-ACL group. However, there were no subsequent admissions, readmissions, or emergency room visits for pain. All were satisfied with the outpatient nature of this surgery. Patients tolerate outpatient endoscopic ACL reconstruction with moderate pain and narcotic use. Outpatient endoscopic ACL reconstruction can be performed safely, effectively, and with considerable cost savings.
进行了一项前瞻性研究，以评估一组50例行门诊前交叉韧带（ACL）重建术患者的术后疼痛和镇痛情况，并将其与一组50例行门诊非ACL关节镜手术患者的情况进行比较。所有患者术前和术后均接受酮咯酸、切口内/关节内布比卡因、术中酮咯酸和丙泊酚麻醉。ACL组在恢复室接受补充镇痛的患者百分比为49%（平均静脉注射硫酸吗啡2.2mg），非ACL组为31%（平均静脉注射硫酸吗啡1.2mg）。两组的麻醉药物使用和疼痛评分在术后第1天和第2天达到峰值。ACL组在术后第一周使用的麻醉药物明显更多，疼痛评分也高于非ACL组。然而，随后没有因疼痛而再次入院、重新入院或前往急诊室就诊的情况。所有患者都对该手术的门诊性质感到满意。患者能够耐受门诊内镜下ACL重建术，疼痛和麻醉药物使用程度适中。门诊内镜下ACL重建术可以安全、有效地进行，并且能节省大量费用。
