Postoperative analgesia for outpatient arthroscopic knee surgery with intraarticular clonidine and/or morphine
Postoperative analgesia for outpatient arthroscopic knee surgery with intraarticular clonidine and/or morphine
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DOI：
10.1097/00000539-200005000-00018
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发表时间：
2000-05-01
影响因子：
5.7
通讯作者：
Maciolek, H
中科院分区：
文献类型：
--
作者：
Joshi, W;Reuben, SS;Maciolek, H
当通过关节内（IA）途径给药时，可乐定（a(2)激动剂）和吗啡（阿片类激动剂）都能增强膝关节镜手术后患者的镇痛作用。可乐定在动物模型中增强吗啡镇痛作用。我们设计这项研究是为了确定可乐定或吗啡是否能产生更好的镇痛效果，以及它们的联合是否能提供比单独使用任何一种药物更好的镇痛效果。我们评估了60例在局部麻醉镇静下接受关节镜下膝关节半月板修复术的患者。术后患者随机分为4个IA组：B组给予0.25%布比卡因30 mL；BC组给予0.25%布比卡因30 mt，可乐定1 μ g/kg；BM组给予0.25%布比卡因30 mt，吗啡3 mg；BCM组给予0.25%布比卡因30 mt，可乐定1 mu g/kg，吗啡3 mg。这项研究揭示了单独服用可乐定和吗啡的显著益处。与单独使用任何一种药物相比，这些药物的联合使用减少了术后疼痛和止痛药的使用，并且增加了镇痛持续时间。我们得出结论，与单独使用任何一种药物相比，IA可乐定和吗啡可以改善膝关节镜检查患者的舒适度。
Both clonidine, an a(2) agonist, and morphine, an opioid agonist provide enhanced patient analgesia after arthroscopic knee surgery when administered via the intraarticular (IA) route. Clonidine potentiates morphine analgesia in the animal model. We designed this study to determine whether clonidine or morphine results in better analgesia and whether their combination would provide superior analgesia to either drug alone. We evaluated 60 patients undergoing arthroscopic knee meniscus repair under local anesthesia with sedation. After surgery, patients were randomized into four IA groups: Group B received 30 mL 0.25% bupivacaine; Group BC received 30 mt 0.25% bupivacaine and clonidine 1 mu g/kg; Group BM received 30 mt 0.25% bupivacaine and morphine 3 mg; and Group BCM received 30 mt 0.25% bupivacaine, clonidine 1 mu g/kg, and morphine 3 mg. This study revealed a significant benefit from the individual IA administration of both clonidine and morphine. The combination of these drugs resulted in decreased postoperative pain and analgesic use, as well as an increased analgesic duration compared with either drug alone. We conclude that IA clonidine and morphine improved comfort compared with either drug alone in patients undergoing knee arthroscopy.