关节内注射吗啡加地塞米松对膝关节镜术后疼痛的影响

Abd-Elazeem El Bakry, W. Sultan
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引用次数: 1

摘要

背景:膝关节镜术后镇痛是恢复和早期康复的必要条件。关节内用药可延长术后镇痛时间,改善疼痛质量。本研究拟研究地塞米松联合关节内吗啡对膝关节镜术后疼痛的影响。患者与方法对90例膝关节镜手术患者进行随机双盲对照研究。患者被随机分为三组。所有药物均于手术结束时关节内注射。对照组患者在生理盐水中给予0.5%布比卡因。M组患者给予吗啡5 mg,加0.5%布比卡因;MD组患者给予吗啡5 mg,地塞米松8 mg,加0.5%布比卡因。记录生命体征、静息和运动疼痛视觉模拟评分、镇痛持续时间、总镇痛用量及不良反应。结果与其他两组相比,MD组静止和运动时的视觉模拟评分较低,术后镇痛时间延长,总镇痛消耗减少(P<0.05)。结论膝关节镜术后在吗啡关节内加用地塞米松可延长镇痛时间,降低疼痛评分,减少总镇痛用量,且不良反应最小。
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The effects of adding dexamethasone to intra-articular morphine injection on postoperative pain after knee arthroscopy
Background Postoperative analgesia after knee arthroscopy is mandatory for recovery and early rehabilitation. Medications were used intra-articularly to prolong postoperative analgesia and improve the quality of pain. The present study was scheduled to study the effects of dexamethasone addition to intra-articular morphine on postoperative pain after knee arthroscopy. Patients and methods This randomized double-blinded controlled study was carried out on 90 patients undergoing knee arthroscopy. The patients were randomly allocated into three equal groups. All medications were injected intra-articularly at the end of surgery. In the control group, the patients were administered 0.5% bupivacaine in normal saline. In M group, the patients were administered 5 mg morphine added to bupivacaine 0.5%. In MD group, the patients were administered 5 mg morphine and 8 mg dexamethasone added to bupivacaine 0.5%. Vital signs, visual analog score for pain at rest and movement, duration of analgesia, total analgesic consumption and adverse effects were recorded. Results MD Group showed lower visual analog score at rest and movement, prolonged postoperative analgesia, and decreased total analgesic consumption compared with the other groups (P<0.05). Conclusion The addition of dexamethasone to intra-articular morphine after knee arthroscopy prolongs the duration of analgesia, lowers pain scores, and decreases total analgesic consumption with minimal adverse effects.
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