关节镜下膝关节手术术后镇痛:关节内可乐定与右美托咪定的比较

Chaitali Biswas, A. Roy, D. P. Bhattacharjee, Suhrita Paul
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引用次数: 0

摘要

背景:关节镜手术与不同程度的术后疼痛相关,有时疼痛相当大。为了提供关节镜下膝关节手术后的术后镇痛,各种药物已在关节内施用。目的:比较膝关节镜手术患者关节内注射可乐定和右美托咪定作为佐剂与局麻药左布比卡因的术后镇痛效果。方法:60例接受选择性膝关节镜检查的患者随机分为以下两组,每组20例。L组患者关节内注射0.25%左布比卡因19 ml,等渗盐水1 ml(共20 ml)。C组患者关节内注射可乐定150µg [1ml],加入0.25%左布比卡因19 ml(总容积20 ml)。D组患者关节内注射右美托咪定100µg (1ml),加入0.25%左布比卡因19 ml(总容积20 ml)。通过测量疼痛强度(VAS评分)和镇痛持续时间评价镇痛效果。结果:与L组(6.18±1.8小时)相比,C组(10.44±4.6小时)和D组(10.72±5.6小时)关节内注射研究药物与首次需要补充镇痛药的时间延迟更长。C组和d组术后24小时双氯芬酸钠总用量明显减少,无明显副作用。结论:关节镜下膝关节手术患者左布比卡因辅助使用可乐定和右美托咪定均可提高术后镇痛质量和持续时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
POST-OPERATIVE ANALGESIA IN ARTHROSCOPIC KNEE SURGERY: A COMPARISON BETWEEN INTRA-ARTICULAR CLONIDINE AND DEXMEDETOMIDINE
Background: Arthroscopic surgery is associated with variable amount of postoperative pain and sometimes the pain is considerable. To provide postoperative analgesia after arthroscopic knee surgery, various medications have been administered intra-articularly. Aim: To compare the postoperative analgesic effects of intra-articular clonidine and dexmedetomidine administered as adjuvants with local anesthetic levobupivacaine in patients undergoing arthroscopic knee surgery. Methods: Sixty patients undergoing elective knee arthroscopy were randomly assigned to one of the following groups containing 20 patients each. Group L patients received 19 ml of 0.25% levobupivacaine and 1 ml of isotonic saline (20 ml in total) intra-articularly. Group C patients received 150µg [1ml] of clonidine added to 19 ml of 0.25% levobupivacaine intra-articularly (total volume 20 ml). Group D patients received 100 µg (1 ml) of dexmedetomidine added to 19 ml of 0.25% levobupivacaine intra-articularly (total volume 20 ml). Analgesic effect was evaluated by measuring pain intensity (VAS score) and duration of analgesia. Results: A longer delay was observed between intra-articular injection of study medication and first requirement of supplementary analgesic in group C (10.44 ± 4.6 hours) and in group D (10.72 ± 5.6 hours) compared to group L (6.18 ± 1.8 hours). Total consumption of diclofenac sodium in first 24 hours in postoperative period was significantly less in group C and D. No significant side effects were noted. Conclusion: Both clonidine and dexmedetomidine, added as adjuncts to levobupivacaine in patients undergoing arthroscopic knee surgery, improve the quality and duration of post operative analgesia.
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