关节镜术后止痛药物的临床比较研究

Comparative Clinical Study of Analgesic Medicine after Arthroscopic Operations

目的寻找一种关节腔内给药的方法,使关节镜术后能获得更加满意的止痛效果。方法采用随机双盲方法。160个病人随机分为8组,膝关节镜术后关节腔内分别注入八组药物。术后第8、24、48小时采用视觉模拟疼痛评分方法进行评分,并记录术后哌替啶使用量,用SPSS10.0软件行统计学分析。结果在第8、24h施沛特加吗啡及布比卡因加吗啡获得最佳止痛效果;第48小时各组止痛效果相似。24h内哌替啶消耗量从少到多依次是组6、7、8,组1、3、4、5,组2。24h后各组均未使用哌替啶。结论关节镜术后关节腔内注入施沛特加吗啡能获得最佳止痛效果,并且同时能促进滑膜软骨修复。

Objective To search for a method of intra-articular injected medicine that was more satisfactory for the analgesia after arthroscopic operations. Methods The random and double blind method was used. One hundred and sixty patients were classified into 8 groups randomly. After operations on knees with arthroscopy, one of the eight drugs was injected into the knee joints respectively. At the8^th,24^ th and 48^th hour after the operation, all pauents were estimated by the VAS, and the consumption of Dolantme was recorded, Then statistic analysis was performed on all data with SPSS 10.0. Results After the operation, both of the combination of HA （hyaluronic acid） and morphine and the combination of bupivicaine and morphine got the best analgesia at the 8^th and 24^th hour. Eight groups got the similar result at the 48^th hour. In 24 hours after the operation, the consumption of Dolantine, were the least to the most in Group 6, 7, 8, Group 1, 3, 4, 5 and Group 2 in sequence, After 24 hours, no Dolantine was consumed in all groups because the pain was slight. Conclusion The combination of HA and morphine injected into joints can have the best analgesic effect after arthroscopic operations, and it also can accelerate the recovery of cartilage.