可乐定与新斯的明用于关节镜患者术后镇痛的临床观察_0.docVIP

可乐定与新斯的明用于关节镜患者术后镇痛的临床观察 【关键词】 可乐定 　　【摘要】 目的 比较可乐定与新斯的明单独或联合关节腔内注射对关节镜手术患者术后的镇痛效应。 方法 45例择期关节镜手术患者，ASA～级。术终随机分为4组（n=15）:组1，关节腔内注射150μg可乐定;组2，关节腔内注射500μg新斯的明;组3，关节腔内注射150μg可乐定和500μg新斯的明;组4，关节腔内注射20ml生理盐水（对照组）。术后用视觉模拟评分法（VAS）评估所有患者的疼痛程度。当患者VAS评分40时，肌注哌替啶1mg/kg，并记录两药的副作用。 结果 对照组VAS评分明显高于其余组（P0.05），组1、组2、组3的VAS评分在统计学上差异无显著性（P0.05）。手术结束至首次肌注哌替啶之间时间，对照组与 治疗 组比较差异有显著性（P0.05），需用哌替啶治疗的患者也明显多于治疗组（P0.05）。组1、组3的低血压、心动过缓发生率是45%和20%，对比于组2、组4的4%和0，差异有非常显著性（P0.01）。接受新斯的明的患者恶心发生率与其余组比较差异无显著性（43%和36%）（P0.05）。 结论 关节腔内注射150μg可乐定或500μg新斯的明都产生镇痛效应，但两药联合 应用 镇痛效果并不更明显。 　　关键词 可乐定 新斯的明 关节镜手术 术后镇痛 　　Clinical evaluation of postoperative analgesia by intraarticular clonidine and neostigmine in patients undergoing knee arthroscopy 　　Liu Jin 　　Department of Anesthesiology，East Hospital of Shanghai，Shanghai200120. 　　【Abstract】 Objective To compare the analgesic effect of intraarticular clonidine and neostigmine，used sepa-rately and in combination，in patients undergoing knee arthroscopy.Methods 45ASA～patients scheduled for arthroscopy were allocated randomly in four groups（n=15）at the end of surgery:group，150μg of intraarticular clonidine;group，500μg of intraarticular neostigmine;group，an intraarticular combination of150μg of clonidine and500μg of neostigmine;group（control group），intraarticular20ml0.9%Nacl.Postoperative pain scores were measured on a visual analog scale（VAS）.Meperidine（1mg/kg）was given as a rescue medication when pain score was40.Results VAS scores were lower in the first three groups compared to the intraarticular control group（P0.05）but no significant difference was documented between the treated groups. The time to the first meperidine admin-istration was shorter in the control group compared to the other groups and the meperidine demand was also higher in this group.45%of the patients who had recEived clonidine had at least one episode of hypotension versus4%of those who did not（P0.01）.The incidence of bradycardia was20%and0respectively（P0.01）.The incidence of na