CAJ | 학술논문

目的观察膝关节镜手术后关节腔内注射不同浓度罗哌卡因复合芬太尼的镇痛效果.方法 40例在腰麻-硬膜外联合阻滞下行单侧膝关节镜手术患者,随机分为四组,每组10例.术毕向关节腔内注入等容量( 10 ml)的不同药物.F组芬太尼10μg；R组0.5％罗哌卡因；FR组芬太尼10μg+0.5％罗哌卡因；N组0.9％氯化钠注射液.记录术后第2、4、8、12、24h患者在静息及运动状态(主动弯曲膝关节)的视觉疼痛评分(VAS)及不良反应.结果 2h时各组VAS评分均较低,差异无统计学意义；4、8、12、24h时F组、R组、FR组的VAS评分与N组相比均明显降低(均P＜0.05),其中FR组与F组和R组相比,VAS评分又有明显降低(均P＜0.05),而F组与R组差异无统计学意义.结论关节腔内注射罗哌卡因复合芬太尼镇痛效果优于两者单独应用,而且并发症少,值得临床推广.
목적 관찰슬관절경수술후관절강내주사불동농도라고잡인복합분태니적진통효과.방법 40례재요마-경막외연합조체하행단측슬관절경수술환자,수궤분위사조,매조10례.술필향관절강내주입등용량( 10 ml)적불동약물.F조분태니10μg；R조0.5％라고잡인；FR조분태니10μg+0.5％라고잡인；N조0.9％록화납주사액.기록술후제2、4、8、12、24h환자재정식급운동상태(주동만곡슬관절)적시각동통평분(VAS)급불량반응.결과 2h시각조VAS평분균교저,차이무통계학의의；4、8、12、24h시F조、R조、FR조적VAS평분여N조상비균명현강저(균P＜0.05),기중FR조여F조화R조상비,VAS평분우유명현강저(균P＜0.05),이F조여R조차이무통계학의의.결론 관절강내주사라고잡인복합분태니진통효과우우량자단독응용,이차병발증소,치득림상추엄.
Objective To observe the difference in analgesia effects of ropivacaine with fentanyl used intraarticularly after the single knee arthroscopy procedure.Methods 40 patients performed knee arthroscopy under combined spinal-epidural anaesthesia( CSEA),were randomly divided into 4 groups (n =10),at the end of operation 10mlof different drug at the group F,R,FR and N(fentanyl 10μg,0.5％ ropivacaine,fentanyl 10μg +0.5％ ropivacaine,normal saline)were injected intra-articularly.The antalgic effects of four groups based on standard of VAS were observed at the 2,4,8,12 and 24h after operation.Results The 2h postoperative VAS scores were lower in four groups,the differences in four groups were not significant.The 4,8,12,24h postoperative VAS scores of F,R and FR group were much lower than that of N group ( all P ＜ 0.05 ).Moreover,VAS scores of FR group were much lower than that of F and R group( all P ＜ 0.05 ).No other adverse effects were observed.Conclusion Intra-articular administration of ropivacaine with fentanyl could provide superior postoperative analgesia without side effects.It was an excellent regimen for analgesia after knee arthroscopy.