羅哌卡因與利多卡因聯合用于膝關節鏡術后鎮痛的隨機雙盲安慰劑對照試驗_《中國循證醫學雜志》

作者：

 王健 , 徐莉 , 張蘭 , 羅林麗

四川大學華西醫院麻醉科（成都 610041）;

關鍵詞：

局麻藥羅哌卡因利多卡因關節鏡關節腔內注射術后鎮痛隨機對照試驗

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目的　研究膝關節腔內聯合應用羅哌卡因與利多卡因的鎮痛效果。
方法　采用隨機雙盲安慰劑對照的試驗方法，將90例膝關節鏡手術患者分為3組，每組分別在術畢膝關節腔內注入0.9%生理鹽水（NS組）和羅哌卡因（R組）、羅哌卡因+利多卡因（R+L組），并進行鎮痛評估，記錄術后補救性鎮痛藥總用量。
結果　R組術后2h休息時、術后1~8h運動時的視覺模擬評分(VAS評分)明顯低于NS組（P lt;0.05）。RL組術后0.5～2h休息時及術后清醒至術后24 h運動時的VAS評分明顯低于NS組（P lt;0.05）。
結論　膝關節腔內注射羅哌卡因能明顯減輕患者術后疼痛程度。羅哌卡因+利多卡因關節腔內注射能減輕患者術后清醒即刻的疼痛程度，達到術后早期鎮痛的目的。

引用本文： 王健,徐莉,張蘭,羅林麗. 羅哌卡因與利多卡因聯合用于膝關節鏡術后鎮痛的隨機雙盲安慰劑對照試驗. 中國循證醫學雜志, 2006, 06(8): 557-562. doi: 復制

1.	Rosseland LA, Helgesen KG, Breivik H, et al. Moderate-to-severe pain after knee arthroscopy is relieved by intraarticular saline: a randomized controlled trial. Anesth Analg, 2004 ; 98(6):1546-1551.
2.	Dye SF,Vaupel GL,Dye CC. Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anesthesia. Am J Sports Med, 1998;26 (6):773-777.
3.	Convery PN, Milligan KR, Quinn P, et al. Efficacy and uptake of ropivacaine and bupivacaine after single intra-articular injection in the knee joint. Br J Anaesth, 2001 ;87(4):570-576.
4.	Franceschi F, Rizzello G, Cataldo R, et al.Comparison of morphine and ropivacaine following knee arthroscopy. Arthroscopy, 2001;17(5):477-480.
5.	Muller M, Burkhardt J, Borchardt E, et al.Postoperative analgesic effect after intra-articular morphine or ropivacaine following knee arthroscopy - a prospective randomized, doubleblinded study. Schmerz, 2001;15(1):3-9.
6.	Rosseland LA, Stubhaug A. Gender is a confounding factor in pain trials: women report more pain than men after arthroscopic surgery. Pain, 2004;112 (3): 248-253.
7.	Reiz S, Haggmark S, Johansson G, et al.Cardiotoxicity of ropivacaine-a new amide local anesthetic agent. Acta Anaesth Scand, 1989;33 (2):93-98.
8.	Feldman HS, Arthur GR, Covino BG. Comparative systemic toxicity of convulsant and supraconvulsant doses of intravenous ropivacaine ,bupivacaine and lidocaine in the conscious dogs. Anesth Analg,1989;69 (6):794-801.
9.	Cederlhom I, Evers H, Lofstrom JB. Skin blood flow after intradermal injection of ropivacaine in various concentrations with or without epinephrine evaluated by laser Doppler flow-metry. Reg Anesth, 1992;17 (6):322-328.
10.	Martinsson T, Haegerstrand A, Dalsgaard CJ. Effect of ropivacaine on eicosanoid release from human granulocytes and endothelial cells in vitro. Inflamm Res, 1997;46 (10):398-403.

1. Rosseland LA, Helgesen KG, Breivik H, et al. Moderate-to-severe pain after knee arthroscopy is relieved by intraarticular saline: a randomized controlled trial. Anesth Analg, 2004 ; 98(6):1546-1551.
2. Dye SF,Vaupel GL,Dye CC. Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anesthesia. Am J Sports Med, 1998;26 (6):773-777.
3. Convery PN, Milligan KR, Quinn P, et al. Efficacy and uptake of ropivacaine and bupivacaine after single intra-articular injection in the knee joint. Br J Anaesth, 2001 ;87(4):570-576.
4. Franceschi F, Rizzello G, Cataldo R, et al.Comparison of morphine and ropivacaine following knee arthroscopy. Arthroscopy, 2001;17(5):477-480.
5. Muller M, Burkhardt J, Borchardt E, et al.Postoperative analgesic effect after intra-articular morphine or ropivacaine following knee arthroscopy - a prospective randomized, doubleblinded study. Schmerz, 2001;15(1):3-9.
6. Rosseland LA, Stubhaug A. Gender is a confounding factor in pain trials: women report more pain than men after arthroscopic surgery. Pain, 2004;112 (3): 248-253.
7. Reiz S, Haggmark S, Johansson G, et al.Cardiotoxicity of ropivacaine-a new amide local anesthetic agent. Acta Anaesth Scand, 1989;33 (2):93-98.
8. Feldman HS, Arthur GR, Covino BG. Comparative systemic toxicity of convulsant and supraconvulsant doses of intravenous ropivacaine ,bupivacaine and lidocaine in the conscious dogs. Anesth Analg,1989;69 (6):794-801.
9. Cederlhom I, Evers H, Lofstrom JB. Skin blood flow after intradermal injection of ropivacaine in various concentrations with or without epinephrine evaluated by laser Doppler flow-metry. Reg Anesth, 1992;17 (6):322-328.
10. Martinsson T, Haegerstrand A, Dalsgaard CJ. Effect of ropivacaine on eicosanoid release from human granulocytes and endothelial cells in vitro. Inflamm Res, 1997;46 (10):398-403.

《中國循證醫學雜志》

羅哌卡因與利多卡因聯合用于膝關節鏡術后鎮痛的隨機雙盲安慰劑對照試驗

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《中國循證醫學雜志》

羅哌卡因與利多卡因聯合用于膝關節鏡術后鎮痛的隨機雙盲安慰劑對照試驗

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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