鸡尾酒关节内注射在膝关节镜术后镇痛的临床应用
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摘要
目的:探讨"鸡尾酒"关节内注射在膝关节镜治疗半月板损伤术后镇痛的临床效果。方法:将2017年7月至2018年7月在安徽医科大学附属阜阳医院骨科收治的50例半月板损伤患者按术后不同干预方法随机分为两组,每组25人,A组(实验组):术后关节腔内注射"鸡尾酒"(玻璃酸钠注射液4mL、罗哌卡因注射液3mL、复方倍他米松注射液1mL,生理盐水2mL);B组(对照组):术后关节腔内注射生理盐水10mL。比较两组患者术后3h、6h、12h、24h、2d、3d、5d、7d膝关节疼痛视觉模拟评分(visual analogue scale,VAS)、住院时间、辅助止痛药物用量、膝关节功能Lysholm评分及不良反应。结果:两组患者在术后7d内均未发现明显不良反应。术后3d内在VAS评分、住院时间、辅助止痛药物艾瑞昔布用量及Lysholm评分方面,A组具有明显优势(P<0.05)。结论:"鸡尾酒"关节腔内注射在膝关节镜治疗半月板损伤术后镇痛效果明显,值得推荐。
Objective: To explore the clinical effect of "cocktail" intraarticular injection in the treatment of meniscus injury by knee arthroscope. Methods: 50 patients with meniscus injury admitted to the department of orthopedics of fuyang hospital of anhui medical university from July 2017 to July 2018 were randomly divided into two groups,25 patients in each group, Group A(experimental group) was given intraarticular injection of "cocktail"(sodium hyaluronate injection 6 ml, ropivacaine injection 3 ml, compound betamethasone injection 1 ml and normal saline 2 ml) and group B(control group)was given intraarticular injection of normal saline 10 ml. Compared of two groups with visual analog scale(VAS),hospital stays,usage amount of imrecoxib, Lysholm and adverse reactions. Results: All patients had no serious complications were found in 7 days postoperatively.Within 3 days after operation, the VAS score,hospital stays,consumption of analgeics and the Lysholm score were better in A group(P<0.05). Conclusion: The "cocktail" intra-articular injection is recommended for obvious analgesic effect after the treatment of meniscus injury with knee arthroscope.
Objective: To explore the clinical effect of "cocktail" intraarticular injection in the treatment of meniscus injury by knee arthroscope. Methods: 50 patients with meniscus injury admitted to the department of orthopedics of fuyang hospital of anhui medical university from July 2017 to July 2018 were randomly divided into two groups,25 patients in each group, Group A(experimental group) was given intraarticular injection of "cocktail"(sodium hyaluronate injection 6 ml, ropivacaine injection 3 ml, compound betamethasone injection 1 ml and normal saline 2 ml) and group B(control group)was given intraarticular injection of normal saline 10 ml. Compared of two groups with visual analog scale(VAS),hospital stays,usage amount of imrecoxib, Lysholm and adverse reactions. Results: All patients had no serious complications were found in 7 days postoperatively.Within 3 days after operation, the VAS score,hospital stays,consumption of analgeics and the Lysholm score were better in A group(P<0.05). Conclusion: The "cocktail" intra-articular injection is recommended for obvious analgesic effect after the treatment of meniscus injury with knee arthroscope.
引文
[1] 李志昌,林剑浩,倪磊.非创伤性半月板损伤关节镜下观察分析[J].中华骨科杂志,2015,35(8):813～818.
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[5] Rabinow B,Werling J,Bendele A,et al.Intra-articular (IA) ropivacainemicroparticle suspensions reduce pain,inflammation,cytokine,andsubstance p levels significantly more than oral or IA celecoxib in a ratmodel of arthritis[J].Inflammation,2015,38(1):40～60.
[6] Rokhtabnak F,Ale Bouyeh M R,Seyed S A,et al.Comparison ofthe effects of intra-articular sole ropivacaine and combined ketorolacand ropivacaine for pain control after knee arthroscopy surgery[J].Br Pain,2015,9(3):149～156.
[2] Hoofwijk D M,Fiddelers A A,Emans P J,et al.Prevalence and predictive factorsof chronic postsurgical pain and global surgical recovery 1 year after outpatient knee arthroscopy:a prospective cohort study[J].Medicine (Baltimore),2015,94(45):e2017.
[3] Levillain A,Magoariec H,Boulocher C,et al.Effects of aviscos upplementation therapy on rabbit menisci in an anteriorcruciate ligament transection model of osteoarthritis[J].Biomech,2017,58:147～154.
[4] 中国医师协会骨科医师分会运动医学专业委员会.玻璃酸钠在骨科和运动医学相关疾病中的应用专家共识(2017年修订版)[J].中国医学前沿杂志(电子版),2017,9(11):3.
[5] Rabinow B,Werling J,Bendele A,et al.Intra-articular (IA) ropivacainemicroparticle suspensions reduce pain,inflammation,cytokine,andsubstance p levels significantly more than oral or IA celecoxib in a ratmodel of arthritis[J].Inflammation,2015,38(1):40～60.
[6] Rokhtabnak F,Ale Bouyeh M R,Seyed S A,et al.Comparison ofthe effects of intra-articular sole ropivacaine and combined ketorolacand ropivacaine for pain control after knee arthroscopy surgery[J].Br Pain,2015,9(3):149～156.