摘要
目的观察膝关节镜术后关节腔内应用不同剂量的药物镇痛作用的差异。方法80例硬膜外麻醉下行膝关节镜手术患者（ASAⅠ-Ⅱ级），随机分为四组（n=20）。术后向关节腔内注入不同剂量的吗啡。C组（对照组）：生理盐水30ml，M1组：2mg吗啡＋0.5％布比卡因，M2组：4mg吗啡＋0.5％布比卡因，M3组：6mg吗啡＋0.5％布比卡因，给药后8、24小时在病人双足站立膝关节伸展状态下进行视觉摸拟评分（VAS）。结果给药后8和24小时VAS评分为：吗啡组显著低于对照组（P〈0．05），M1、M2、M3各组之间无显著差异（P〉0.05），M3组有2例出现皮肤瘙痒。结论M2组可以有效缓解膝关节手术后的疼痛，且无任何副作用。
Objective To evaluate the difference in analgesia effects of different dosage of morphine used intraarticularly after knee arthroscopy. Methods Eighty patients with ASA Physical Status Ⅰ to Ⅱ, undergoing knee arthroscopy, were randomly divide into 4 groups equally （ n = 20）. All patients received continuous epidural anesthesia（ L3-4 ）. At the end of surgery, the following drugs were injected intraarticularly through the arthroscope： group C, normal saline soiution 30ml; group M1,2mg morphine in 0.5% bupivacaine; group M2, 4mg morphine in 0.5% bupivacaine ; group M3, 6 mg morphine in 0.5% bupivacaine; Analgesic efficacy was evaluated by visual analogue scale（VAS） 8 and 24 hours after the administration of morphine or placebo,this was done with the patients standing on both legs with extended knees. Results 8 hours and 24 hours after administration, the scores of YAS were lower in group morphine than in group C （P 〈 0.05 ）, there were no statistical difference in among the group of morphine （ P 〉 0.05 ） ; Two patients had epidermis itch in group M3 , no other adverse effects were noted. Conclusion The group M2 can effectively relieve the pain after arthroscopic knee surgery and no any adverse effect.
关键词
术后镇痛
关节镜
吗啡
布比卡因
Postoperative analgesia Arthroscopy Morphine
Bupivacaine
