关节腔内注射左旋布比卡因的镇痛效果及安全性

The Analgesic Efficiency and Safety of Levobupivacaine for Intra-articular Injection

目的探讨膝关节镜术后关节腔内注射左旋布比卡因的镇痛效果及安全性。方法90例择期膝关节镜手术患者，随机分为罗哌卡因组、左旋布比卡因组和布比卡因组（n=30）。手术结束后分别于膝关节腔内注射0．5％罗哌卡因、左旋布比卡因和布比卡因20ml。观察并记录注药后2、4、8、12、24和48h视觉模拟评分（VAS），同时记录注药后发生的不良反应。结果术后三组镇痛满意率分别为80％，96．7％和93．3％（P〈0．05）；三组的VAS逐渐增加，8～24hB组和L组VAS低于R组，差异有统计学意义（P〈0．05）。所有患者均无严重不良反应发生。结论膝关节腔内注射左旋布比卡因，镇痛效果好，无严重不良反应，可安全用于膝关节镜手术后镇痛。

Objeceyive To investigate the analgesic efficiency and safety of levobupivacaine for single intra - articular injection. Method 90 patients scheduled for knee arthroscopy were randomly devided into Ropivacaine group, Levobupivacaine group and Bupivacaine group; and were injected intra - articularly 0.5 % Ropivacaine, Levobupivacaine or Bupivacaine after the operation, respectively. Observed and recorded the VAS at 2,4,8,12,24 and 48h, at the same time recorded the adverse reactions occurred after the injection. Result The analgesic satisfaction of patients was 80 %, 96.7 % and 93.3 %. VAS increased gradually after the operation, and VAS of B and L group was significantly lower than R group between 4 and 24 h. No serious adverse reaction occurred in all patients. Conclusion Levobupivacaine for intra - articular injection is effective with few adverse reactions, so it can be used for analgesic after knee arthroscopy safely.