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[关节镜下膝关节手术后关节腔内注射局部麻醉药布比卡因和α2激动剂可乐定用于术后镇痛]

[Postoperative analgesia with intraarticular local anesthetic bupivacaine and alpha2-agonist clonidine after arthroscopic knee surgery].

作者信息

Tamosiūnas Ramūnas, Brazdzionyte Egle, Tarnauskaite-Augutiene Armida, Tranauskaite-Keraitiene Grazina

机构信息

Clinic of Anesthesiology, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2005;41(7):547-52.

Abstract

OBJECTIVE

To evaluate the efficacy of intraarticular 0.5% 20 ml bupivacaine and compound of bupivacaine with alpha2-agonist clonidine for postoperative analgesia after arthroscopic knee surgery. A total of 48 patients, scheduled for knee arthroscopy, were enrolled in the study. Patients were randomly assigned to three different groups: placebo (group C), and two experimental groups that received one of the following double-blinded intraarticular solutions: 0.5% 20 ml of bupivacaine (group B) and 0.5% 20 ml of bupivacaine with l microg/kg of clonidine (group B+C). Patients were asked to evaluate on a visual analogy scale (VAS) the intensity of pain at rest and during motion, satisfaction with postoperative analgesia. Side effects and requirements for supplemental analgetics were recorded at the same time.

RESULTS

Postoperative analgesia was good in the groups B and B+C (VAS<3). The pain was controlled most effectively in the patients of group B+C compared to placebo group (p<0.05). The demand for supplemental analgetics after surgery was also lower in this group. The patients of group B+C had shown the most satisfaction with postoperative analgesia.

CONCLUSION

The compound of intraarticular bupivacaine and clonidine suppresses pain better than intraarticular injection of bupivacaine or use of usual systemic analgetics (p<0.05). Intraarticular analgesia assures satisfaction with anesthesiologic procedure.

摘要

目的

评估关节腔内注射20毫升0.5%布比卡因以及布比卡因与α2-激动剂可乐定的复合物用于膝关节镜手术后镇痛的效果。共有48例计划接受膝关节镜检查的患者纳入本研究。患者被随机分为三组:安慰剂组(C组),以及两个试验组,分别接受以下双盲关节腔内注射溶液之一:20毫升0.5%布比卡因(B组)和20毫升含1微克/千克可乐定的0.5%布比卡因(B+C组)。要求患者通过视觉模拟评分法(VAS)评估静息和活动时的疼痛强度、对术后镇痛的满意度。同时记录副作用和补充镇痛药的需求情况。

结果

B组和B+C组术后镇痛效果良好(VAS<3)。与安慰剂组相比,B+C组患者的疼痛控制最为有效(p<0.05)。该组术后补充镇痛药的需求也较低。B+C组患者对术后镇痛的满意度最高。

结论

关节腔内注射布比卡因与可乐定的复合物比关节腔内注射布比卡因或使用常规全身镇痛药能更好地抑制疼痛(p<0.05)。关节腔内镇痛可确保患者对麻醉程序满意。

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