- 期刊
Analgesic Effect of Intra-articular Morphine after Arthroscopic Knee Surgery in Chinese Patients
中國人經膝關節鏡手術後關節內注射嗎啡的止痛作用
摘要
Background: Small or systematically inactive doses of morphine administered into the knee joint during intra-articular surgery can elicit potent and long-lasting postoperative analgesia. The reports studied in USA, Spain, UK, Germany, Ireland, etc. showed that intra-articular morphine 0.5 - 5 mg could produce a significant analgesic effect with an onset time of 0 - 6 h after administration and a duration of 24-48 h. However, there were no available data about the Chinese people; therefore, this study was designed to collect the data regarding this subject. Methods: Forty patients undergoing arthroscopic knee surgery under spinal anesthesia were randomly divided into two groups. At the end of surgery, group 1 received intra-articular morphine sulfate 1 mg in normal saline 10 ml, while group 2 received intra-articular 0.5% bupivacaine 10 ml for postoperative pain relief. Results: The results showed that all pain scores were lower in morphine group than in bupivacaine group from 6 to 24 h after surgery. Supplemental analgesic consumption was significantly greater in the bupivacaine group than in the morphine group from 6 to 24 h postoperatively. These results were quite similar with those presented in other races. Conclusions: We concluded that intra-articular morphine 1 mg in Chinese patients could provide an effective and long-lasting analgesic effect, which was quite similar with the result presented in other races.
並列摘要
背景：對於接受膝關節手術之病患於手術中注入小劑量的嗎啡於膝關節中可以產生強而有效且持久的術後止痛作用。在美國、西班牙、英國、德國、及愛爾蘭等國家皆有報告指出關節內注射0.5至5毫克嗎啡可以產生有意義的止痛效果，其起始作用時間約於給藥後零至六小時，且止痛效果可持續達24至48小時。然而，在這方面中國人的資料卻付之闕如。因此，我們乃以中國人為研究對象，從事相關類似的研究。方法：我們將40位進行脊髓麻醉並接受膝關節鏡手術之病患任意分為兩組。於手術結束前，第一組病患給予關節內注射嗎啡1毫克（溶於10毫升生理食鹽水中），第二組則直接注射0.5% bupivacaine 10毫升做為術後止痛。結果：結果顯示給予嗎啡之病患的疼痛分數從術後6至24小時都比給予bupivacaine者來得低，同時所需額外之止痛劑的消耗量亦有意義地較少。此結果與上述各國之報告是相當類似的。結論：我們的結論是中國人於膝關節鏡手術後，關節內注射嗎啡1毫克與其他種族一樣可以提供有效且長時間的術後止痛作用。
延伸閱讀
- Liu, K., Wang, J. J., Ho, S. T., Liaw, W. J., & Chia, Y. Y. (1995). 類鴉片藥物之周邊鎮痛作用：膝關節手術後關節內注射嗎啡的止痛作用. Acta Anaesthesiologica Sinica, 33(4), 217-221. https://www.airitilibrary.com/Article/Detail?DocID=P20170519003-199512-201904170005-201904170005-217-221
- Tan, P. H., Chia, Y. Y., Perng, J. S., Chou, A. K., Chung, H. C., & Lee, C. C. (1997). 使用嗎啡於間歇式硬脊膜外與病患自控式硬脊膜外術後止痛之比較. Acta Anaesthesiologica Sinica, 35(3), 149-154. https://www.airitilibrary.com/Article/Detail?DocID=P20170519003-199709-201904160020-201904160020-149-154
- Lin, P. C., Hsu, C. H., Wang, J. W., & Chen, W. S. (2009). 微創全人工膝關節置換術後使用Tranexamic acid減少術後出血的成效. Journal of Orthopaedic Surgery Taiwan, 26(4), 198-205. https://www.airitilibrary.com/Article/Detail?DocID=10116923-200912-201001150086-201001150086-198-205
- Chen, C. P. C., Chen, C. K., Chen, M. J. L., Lin, Y. C., Hsu, T. H. C., Cheng, J. W., & Tang, S. F. T. (2004). 膝關節內注射玻尿酸對退化性膝關節炎患者臨床疼痛症狀及日常生活功能之效應. 台灣復健醫學雜誌, 32(3), 111-116. https://doi.org/10.6315/2004.32(3)01
- 江秀珠（2009）。探討膝退化性關節炎病患以玻尿酸關節內注射之療效分析〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-1908200909310700