药物联合应用在膝骨关节炎关节镜清理术后止痛的研究

目的观察联合应用玻璃酸钠 利多卡因 地塞米松在膝骨关节炎关节镜清理术后止痛作用。方法实验采用双盲随机分组,膝骨关节炎关节镜清理术病人50例,58膝,分为玻璃酸钠(2 ml) 2%利多卡因(2.5 ml) 地塞米松(2.5 mg)(A组,n=15),玻璃酸钠(2 ml) 生理盐水(5 ml)(B组,n=15),2%利多卡因(2.5 ml) 生理盐水(4.5ml)(C组,n=15),地塞米松(2.5 mg) 生理盐水(4.5 ml)(D组,n=13),每例患者于术后关节腔注射,分别在给药后8 h、24 h、72 h、一周时,在病人双足站立膝关节伸展状态下进行视觉模拟评分(VAS),结果用q检验。结果术后8h,A组和C组的止痛效果好于B组和D组(P<0.05)但术后72 h和一周时B组和A组的止痛效果明显好于C组和D组(P<0.05)。结论膝骨关节炎关节镜清理术后联合应用玻璃酸钠 利多卡因 地塞米松在早期止痛和持续镇痛方面有较为满意的临床效果。

Analgesic effect of intra-articular injection of sodium hyaluronate, dexamethasone and lidocaine after arthroscopic debridement for osteoarthritis of the knee

Objective To investigate the analgesic effect of intra-aticular injection of sodium hyaluronate(SH),dexamethasone(DXM) and lidocaine(LID) following the arthroscopic debridement for osteoarthritis of the knee.Methods In this prospective double-blind study,50 patients(58 knees) with osteoarthritis of the knee were randomly assigned to receive SH(2 ml) LIN(2.5 ml) DXM(2.5 mg)(group A,n=15),SH(2 ml) NS(5 ml)(group B,n=15),LIN(2.5 ml) NS(4.5 ml)(group C,n=15) or DXM(2.5 mg) NS(4.5 ml)(group D n=13) at the end of arthroscopic surgery.The analgesic efficacy was tested by a visual analog scale(VAS) at 8,24,72 hours and 1 week after operation.Results The analgesic efficacy in group A and C was significantly better than that in B group and D group 8 hours after operation(P<0.05),But the analgesic efficacy in group A and B was significantly better than that in C group and D group 72 hours and 1 week after operation(P<0.05).Conclusion Intra-aticular injection of SH,LIN and DXM after arthroscopic debridement for osteoarthritis can effectively relieve pain in the knee joint.