Wang J J, Ho S T, Lee S C, Tang J J, Liaw W J
Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Anesth Analg. 1998 Nov;87(5):1113-6. doi: 10.1097/00000539-199811000-00024.
Intraarticular corticosteroids provide valuable local therapy for chronic joint pain caused by inflammatory joint diseases. In this inpatient study, we evaluated the effect of intraarticular triamcinolone acetonide on acute pain after arthroscopic knee surgery. Sixty patients who underwent arthroscopic knee surgery under spinal anesthesia were enrolled into this double-blind, randomized trial. At the end of surgery, Group 1 (n = 30) received intraarticular triamcinolone acetonide 10 mg in isotonic saline 20 mL, and Group 2 (n = 30) received intraarticular isotonic saline 20 mL. After surgery, pain was assessed by using a visual analog scale. The time to first analgesic request (IV morphine) was recorded, and the proportion of patients requiring rescue analgesia was calculated. The results demonstrated that patients in Group 1 had lower pain scores than those in Group 2 from 6 to 24 h postoperatively (P < 0.05 to P < 0.01). From 6 h to 24 h, no patient in Group 1, compared with 53% of patients in Group 2, requested rescue analgesia (P < 0.001). We conclude that intraarticular triamcinolone acetonide provides a valuable local therapy of acute joint pain after arthroscopic knee surgery.
The value of intraarticular triamcinolone acetonide in the management of pain after arthroscopic knee surgery has been evaluated. Patients who received intraarticular triamcinolone acetonide 10 mg at the end of surgery had lower pain scores and used less systemic analgesia than the saline control group. These data are important to the clinical use of this new therapy.
关节内注射皮质类固醇为炎性关节疾病所致的慢性关节疼痛提供了有价值的局部治疗方法。在这项住院患者研究中,我们评估了关节内注射曲安奈德对膝关节镜手术后急性疼痛的影响。60例在脊髓麻醉下接受膝关节镜手术的患者被纳入这项双盲随机试验。手术结束时,第1组(n = 30)在20 mL等渗盐水中接受10 mg关节内注射曲安奈德,第2组(n = 30)接受20 mL关节内注射等渗盐水。手术后,使用视觉模拟量表评估疼痛。记录首次要求使用镇痛药(静脉注射吗啡)的时间,并计算需要补救性镇痛的患者比例。结果表明,术后6至24小时,第1组患者的疼痛评分低于第2组(P < 0.05至P < 0.01)。从6小时至24小时,第1组无患者要求补救性镇痛,而第2组为53%(P < 0.001)。我们得出结论,关节内注射曲安奈德为膝关节镜手术后的急性关节疼痛提供了有价值的局部治疗方法。
已评估关节内注射曲安奈德在膝关节镜手术后疼痛管理中的价值。手术结束时接受10 mg关节内注射曲安奈德的患者与生理盐水对照组相比,疼痛评分更低,全身镇痛药使用更少。这些数据对这种新疗法的临床应用具有重要意义。