关节腔内注射氯诺昔康复合布比卡因、吗啡或丁丙诺啡用于膝关节镜术后镇痛的效应

李军; 崔德荣

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关节腔内注射氯诺昔康复合布比卡因、吗啡或丁丙诺啡用于膝关节镜术后镇痛的效应

李军 , 崔德荣

文章导航 > 蚌埠医学院学报 > 2008, 33 > 3: (303-306)

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关节腔内注射氯诺昔康复合布比卡因、吗啡或丁丙诺啡用于膝关节镜术后镇痛的效应

李军¹,
崔德荣²

1. 上海市中西医结合医院麻醉科, 上海 200082;
2. 上海交通大学附属第六人民医院麻醉科, 上海 200233

作者简介: 李军(1970-),男,主治医师,现参加援摩洛哥塔塔医疗队.

中图分类号: R684;R916.61

Analgesic effect of lornoxicam or combined with bupivacaine,morphine or buprenorphine injected intra-articularly after knee arthroscopy

LI Jun¹,
CUI De-rong²

1. Department of Anesthesiology, Shanghai TCM-integrated Hospital, Shanghai 200082;
2. Department of Anesthesiology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China
CLC number: R684;R916.61

摘要: 目的:评价关节腔内单独使用氯诺昔康及其配伍布比卡因、吗啡、丁丙诺啡用于膝关节镜术后镇痛的效果。方法:病例选自于摩洛哥王国塔塔医院和塞达特医院,共120例慢性膝关节炎行膝关节镜手术患者,随机分为6组,每组20例。A组:氯诺昔康8 mg;B组:吗啡2 mg;C组:氯诺昔康8 mg+0.5%布比卡因20 ml;D组:吗啡2 mg+0.5%布比卡因20 ml;E组:氯诺昔康8 mg+丁丙诺啡0.1 mg;F组:氯诺昔康8 mg+吗啡2 mg。A、B、E、F组均用生理盐水稀释至20 ml。于手术结束时关节腔内注射药物行术后镇痛。分别记录术后各组0.25、0.5、1、4、8、16、20、24 h在膝关节屈曲90°状态下疼痛程度(PI)、疼痛程度差值(PID)、疼痛缓解程度值(PAR)、镇痛治疗总体印象评分及药物相关副作用。结果:术后0.25、0.5、16、20、24 h,A、B组PID值低于C、D、E、F组(P<0.01),PAR值高于C、D、E、F组(P<0.01)。术后8、16 h A组PID值高于B组(P<0.01),PAR值低于B组(P<0.01)。镇痛治疗总体印象评分在C、D、E、F四组之间无不同,但明显优于A组与B组(P<0.01)。E组有7例、F组有9例出现腹胀、恶心。结论:氯诺昔康复合布比卡因或阿片类药物关节腔内注射用于膝关节镜术后镇痛的效果明显优于其单独用药,但合用阿片类药物可引起轻度胃肠道症状。
- 关节镜术 /
- 镇痛药 /
- 氯诺昔康 /
- 吗啡 /
- 布比卡因 /
- 丁丙诺啡 /
- 注射,关节内
Abstract: Objective: To evaluate the analgesic effect of intra-articular administration of lornoxicam or combined with bupivacaine,morphine or buprenorphine after knee arthroscopy.Methods: One hundred twenty patients from the Hospitals in Tata and the Kindom of Settat in Morocco were assigned to six groups(n=20).Group A received lornoxicam 8 mg in 0.9% NaCl to 20 ml i.a,group B received morphine 2 mg in 0.9% NaCl to 20 ml i.a,group C lornoxicam 8 mg and bupivacaine 0.5% 20 ml i.a,group D morphine 2 mg and bupivacaine 0.5% 20 ml i.a,group E buprenorphine 100 μg and lornoxicam 8 mg in 0.9% NaCl to 20 ml i.a and group F morphine 2 mg and lornoxicam 8 mg in 0.9% NaCl to 20 ml i.a.The intensity of postoperative pain was evaluated by pain intensity(PI),pain intensity difference(PID) and pain relief(PAR) at 0.25,0.5,1,4,8,16,20,24 hour after operation when the passive knee flexion was 90°.The total impression of analgesic effect and side effects related to the drugs were recorded.Results: The PID values were significantly higher in group C,D and F than those in group A and B at 0.25,0.5,16,20,24 h after operation(P<0.01).The PAR values were significantly lower in group C,D,E and F than those in group A and B at 0.25,0.5,16,20,24 h after operation(P<0.01).Group A showed a higher PID value and a lower PAR value compared to group B at 8 and 16 h after operation(P<0.01).The total impression scores of analgesia among group C,D,E and F did not have statistical difference,but their scores were superior to those of the other two groups during the postoperative period(P<0.01).Abdominal distension and nausea were observed in 7 cases in group E and 9 cases in group F.Conclusions: Intra-articular use of lornoxicam combined with bupivacaine,buprenorphine or morphine provides better analgesic effect than the administration of lornoxicam alone after knee arthroscopic surgery.

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关节腔内注射氯诺昔康复合布比卡因、吗啡或丁丙诺啡用于膝关节镜术后镇痛的效应

李军¹
崔德荣²

作者简介: 李军(1970-),男,主治医师,现参加援摩洛哥塔塔医疗队.

1. 上海市中西医结合医院麻醉科, 上海 200082;
2. 上海交通大学附属第六人民医院麻醉科, 上海 200233

收稿日期: 2007-12-21

关键词:

摘要: 目的:评价关节腔内单独使用氯诺昔康及其配伍布比卡因、吗啡、丁丙诺啡用于膝关节镜术后镇痛的效果。方法:病例选自于摩洛哥王国塔塔医院和塞达特医院,共120例慢性膝关节炎行膝关节镜手术患者,随机分为6组,每组20例。A组:氯诺昔康8 mg;B组:吗啡2 mg;C组:氯诺昔康8 mg+0.5%布比卡因20 ml;D组:吗啡2 mg+0.5%布比卡因20 ml;E组:氯诺昔康8 mg+丁丙诺啡0.1 mg;F组:氯诺昔康8 mg+吗啡2 mg。A、B、E、F组均用生理盐水稀释至20 ml。于手术结束时关节腔内注射药物行术后镇痛。分别记录术后各组0.25、0.5、1、4、8、16、20、24 h在膝关节屈曲90°状态下疼痛程度(PI)、疼痛程度差值(PID)、疼痛缓解程度值(PAR)、镇痛治疗总体印象评分及药物相关副作用。结果:术后0.25、0.5、16、20、24 h,A、B组PID值低于C、D、E、F组(P<0.01),PAR值高于C、D、E、F组(P<0.01)。术后8、16 h A组PID值高于B组(P<0.01),PAR值低于B组(P<0.01)。镇痛治疗总体印象评分在C、D、E、F四组之间无不同,但明显优于A组与B组(P<0.01)。E组有7例、F组有9例出现腹胀、恶心。结论:氯诺昔康复合布比卡因或阿片类药物关节腔内注射用于膝关节镜术后镇痛的效果明显优于其单独用药,但合用阿片类药物可引起轻度胃肠道症状。

English Abstract

Analgesic effect of lornoxicam or combined with bupivacaine,morphine or buprenorphine injected intra-articularly after knee arthroscopy

LI Jun¹
CUI De-rong²

1. Department of Anesthesiology, Shanghai TCM-integrated Hospital, Shanghai 200082;
2. Department of Anesthesiology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China

Received Date: 2007-12-21

Abstract: Objective: To evaluate the analgesic effect of intra-articular administration of lornoxicam or combined with bupivacaine,morphine or buprenorphine after knee arthroscopy.Methods: One hundred twenty patients from the Hospitals in Tata and the Kindom of Settat in Morocco were assigned to six groups(n=20).Group A received lornoxicam 8 mg in 0.9% NaCl to 20 ml i.a,group B received morphine 2 mg in 0.9% NaCl to 20 ml i.a,group C lornoxicam 8 mg and bupivacaine 0.5% 20 ml i.a,group D morphine 2 mg and bupivacaine 0.5% 20 ml i.a,group E buprenorphine 100 μg and lornoxicam 8 mg in 0.9% NaCl to 20 ml i.a and group F morphine 2 mg and lornoxicam 8 mg in 0.9% NaCl to 20 ml i.a.The intensity of postoperative pain was evaluated by pain intensity(PI),pain intensity difference(PID) and pain relief(PAR) at 0.25,0.5,1,4,8,16,20,24 hour after operation when the passive knee flexion was 90°.The total impression of analgesic effect and side effects related to the drugs were recorded.Results: The PID values were significantly higher in group C,D and F than those in group A and B at 0.25,0.5,16,20,24 h after operation(P<0.01).The PAR values were significantly lower in group C,D,E and F than those in group A and B at 0.25,0.5,16,20,24 h after operation(P<0.01).Group A showed a higher PID value and a lower PAR value compared to group B at 8 and 16 h after operation(P<0.01).The total impression scores of analgesia among group C,D,E and F did not have statistical difference,but their scores were superior to those of the other two groups during the postoperative period(P<0.01).Abdominal distension and nausea were observed in 7 cases in group E and 9 cases in group F.Conclusions: Intra-articular use of lornoxicam combined with bupivacaine,buprenorphine or morphine provides better analgesic effect than the administration of lornoxicam alone after knee arthroscopic surgery.