【摘要】 目的 :观察关节腔内注射丁丙诺啡 (Buprenorphine)对膝关节镜术后的镇痛效果 ,并与注射小剂量吗啡 (Morphine)进行对比分析。方法 :4 8例腰麻下行膝关节镜手术病人 ,双盲法随机均分为关节腔内注射Buprenorphine(B)、Morphine(M )与生理盐水对照组 (C) 3组 ,给药后记录术后 2h、4h、8h、12h与 2 4h患者屈膝关节 90°状态下的视觉模拟评分 (VAS)、对镇痛效果的满意度及术后8h按需注射哌替啶的量。结果 :B、M组术后 8h哌替啶平均使用量分别为 9.4mg与 2 8.1mg ,较C组 (5 1.6mg)明显减少 ;术后 4h、8h、12h、2 4h患者屈膝 90°VAS评分B、M组均显著低于C组 ,B组亦较M组低 ,比较统计学差异均非常显著 (P <0 .0 0 1) ;术后镇痛满意度 ,B、M组较C组高 ,组间差异非常显著 (P <0 .0 0 1)。结论 :关节腔内注射Buprenorphine可有效缓解膝关节镜术后疼痛 ,效果优于吗啡。更多还原

【Abstract】 Objective:To investigate the analgesic effect of low dose Buprenorphine injected intra-articularly after knee arthroscopy, and compared with that of Morphine. Methods: At the end of surgery, 48 patients with ASA Physical StatusⅠtoⅡ, undergoing knee arthroscopy, were randomly divided to intra-arcularly receive low dose Buprenorphine 0.1 mg (group B, n=16),Morphine 1 mg(group M, n=16) and the same volume of normal saline solution(group C, n=16). After administration of drugs metioned above, visual analogue scale(VAS) was scored immediately after the patients actively flexed the operated knee to 90°. Meanwhile degree of patients’ satisfaction with analgesic effect, the amount of Pethidine injected on patients’ demand during 8 hours after surgery, and side effects were also recorded. Results: During 8 postoperative hours, the amount of Pethidine in group B and group M, which was 9.4 mg and 28.1 mg, respectively, were lower than that in group C. At 2h there was significant statistical difference in VAS between group B or group M and group C. At 4h,8h,12h and 24h postoperatively VAS were much lower in group B than in group M and in group C( P <0.001), and VAS in group M was also lower than in group C. Meanwhile significant difference in degree of patient’s satisfaction with analgesic was found between group B or M and group C( P <0.001). Conclusion: Intra-articularly injected Buprenorphine could provide better postoperative analgesia for patients undergoing knee arthroscopy for up to 24h compared with Morphine.更多还原