关节腔注射右美托咪定对膝关节镜术后镇痛的效果

目的 观察关节腔内注射右美托咪定对膝关节镜术后镇痛的效果.方法 择期行膝关节镜手术患者40例,随机分为生理盐水组（关节腔注射生理盐水20 ml）和右美托咪定组（关节腔注射右美托咪定1 μg/kg加生理盐水配置成20 ml）,每组各20例.于术后1、2、4、6、10、12、24 h时以视觉模拟评分（VAS）评价术后镇痛效果,术后当患者VAS评分≥4时静脉注射氯诺昔康8 mg镇痛,每8小时可重复注射1次.记录术后首次需要氯诺昔康镇痛的时间、术后24 h内氯诺昔康的用量及用药后的不良反应.结果 术后6h内右美托咪定组镇痛效果优于生理盐水组（P＜0.05）,右美托咪定组术后首次需要氯诺昔康镇痛的时间（320±115 min）较生理盐水组（69±46 min）延迟,24 h内总用量（8.7±1.9 mg）低于生理盐水组（16.8±2.5mg）（P＜0.05）.结论 关节腔内注射右美托咪定用于膝关节镜术后镇痛能够产生良好的镇痛效果,延长术后首次需要镇痛药辅助的时间.

Efficacy of intra-articular dexmedetomidine for postoperative analgesia in patients with arthroscopic knee surgery

Objective To observe the efficacy of intra-articular dexmedetomidine for postoperative analgesia in patients after arthroscopic knee surgery. Methods Forty patients undergoing selective knee arthroscopy were randomly assigned to the normal saline group （saline 20 ml injected, n= 20） and the dexmedetomidine group （dexmedetomidine 19g/kg and saline 20 ml injected, n= 20）. Postoperative analgesia effect was measured with VAS at 1, 2 , 4, 6, 10, 12, and 24 h after the operation. Lornoxicam 8 m.g was intravenously injected when VAS≥4, which could repeat every 8 h. The time to first postoperative analgesic request, the total postoperative analgesic dosage used during the first 24 hours, and the adverse effects were recored. Results VAS was significantly lower in the dexmedetomidine group than that in the normal saline group during the first 6 h after the injec- tion （P〈0. 05）. The time to first postoperative analgesic request was longer in the dexmedetomidine group （320± 115 min）, compared with the normal saline group （69 ± 46 min）. Total lornoxicam requirement was significantly fewer in the dexmedetomidine group （8.7 ± 1.9 mg） than that in the normal saline group（16.8 ± 2.5 mg）. Conclusion Intra-articular injection o offer excellent first analgesic postoperative analgesia after arthroscopic knee surgery, with request. f dexmedetomidine can an lengthened time to first analgesic request.