膝关节镜术后关节腔内注射芬太尼和口服美洛昔康的镇痛效果比较

Knee post arthroscopy analgesia with fentanyl and meloxicam

目的:研究膝关节镜术后关节腔内注射芬太尼和口服非甾体类药物(NSAIDs)美洛昔康的镇痛效果。方法:选取择期行膝关节镜手术患者180例,随机分为3组,每组60例,A组术后关节腔内注入芬太尼,并在术后给予美洛昔康口服;B组术后关节腔内注入芬太尼;C组术后给予美洛昔康口服。分别在术后2、8、24、48、72h,以VAS评估患者术后的疼痛水平。结果:2hA组较B组的评分差异无显著性意义。2h后A组评分较B组更低(P<0.05),A组和B组较C组的评分明显降低(P<0.05)。结论:芬太尼与美洛昔康联合使用可以有效缓解膝关节镜术后疼痛,镇痛效果优于单独使用;芬太尼较美洛昔康效果更佳。

Objective：To evaluate the analgesic effects of intraarticular fentanyl and oral meloxicam tablet after knee arthroscopy. Method：One hundred and eighty patients were randomized to three groups. The patients in group A （n=60） received intra-articular fentanyl and oral meloxicam tablet. The patients in group B （n=60） received intraarticular fentanyl. The patients in group C （n=60） received meloxicam tablet. Analgesic efficiency was evaluated by visual analogue scale（VAS） at the 2nd, 8th, 24th, 48th, 72nd hour after the administration of fentanyl or meloxicam tablet. Result： At the 2nd there was no statistical difference in VAS between group A and group B（P〉0.05）. At the 8th, 24th, 48th, 72nd hour VAS were lower in group A than that in group B （P〈0.05）. VAS were lower in groups A and B than that in group C （P〈0.05）. Conclusion：Intraarticular injection of fentanyl 0.1 mg combined with oral meloxicam tablet may provide superior postoperative analgesia versus fentanyl or meloxicam tablet alone. Intraarticular injection of fentanyl may provide superior postoperative analgesia versus oral meloxicam tablet.