【罂粟摘要】单次静脉注射糖皮质激素对膝关节镜术后疼痛的影响:一项前瞻性、双盲、非随机对照临床试验

单次静脉注射糖皮质激素对膝关节镜术后疼痛的影响:一项前瞻性、双盲、非随机对照临床试验

贵州医科大学    麻醉与心脏电生理课题组

翻译：安丽      编辑：宋雨婷      审校：曹莹

背景

目前膝关节镜作为一种标准的手术方式，广泛用于日间手术。本研究的目的是观察单次静脉注射糖皮质激素对接受膝关节镜检查的非骨性手术术后疼痛的影响。

方法

本试验为一项前瞻性双盲研究，共纳入2019年至2022年期间接受膝关节镜检查的60名患者，并将其分为两组。对照组：未给予地塞米松，治疗组：在止血带充气前15分钟静脉给予8mg地塞米松。分别在术前及术后第1天早晨，采用视觉模拟评分（VAS）评估患者做5个不同动作的疼痛情况。

结果

两组患者术前和术后VAS评分无显著差异。治疗组术后吗啡需求量显著减少，未接受地塞米松治疗的患者术后需要使用吗啡的比率为80%，而接受地塞米松治疗的患者术后需要使用吗啡的比率为53.3%（P=0.027）。

结论

术前单次静脉给予地塞米松，可减少膝关节镜术后疼痛所需的阿片类药物剂量。

原始文献来源：

Mohammad Hamdan, Bassem I. Haddad, Ula Isleem, Mohamad Yasin, Mustafa Alrabayah,Hashem Al Hawamdeh, Sharifeh Almasaid, Dayana Jibrin , Mohammad Daas, Saif Aldeen AlRyalat and Mohammad Ali Alshrouf.The Effect of a Single Intravenous Corticosteroid Administration on Pain after Knee Arthroscopy: A Prospective,Double-Blind, Non-Randomized Controlled Clinical Trial. J. Clin.Med.2023,12,197.Doi.org/10.3390/jcm12010197.

英文原文

The Effect of a Single Intravenous Corticosteroid Administration on Pain after Knee Arthroscopy: A Prospective,Double-Blind, Non-Randomized Controlled Clinical Trial

Background:Knee arthroscopy is a standard surgical procedure that is nowadays widely performed as day-case surgery. The aim of the study was to observe the effect of a single dose of intravenous corticosteroid on pain after undergoing knee arthroscopy for non-bony procedures.

Methods:A prospective, double-blind study design was adopted. Patients undergoing knee arthroscopy for non-bony procedures were prospectively assigned into two equal groups: control (those who were not given steroids) and treatment (those who were given eight milligrams of dexamethasone intravenously 15 min prior to the inflation of the tourniquet). The pain was assessed pre-operatively on admission and on the first post-operative day during the morning round in five different movements using a visual analogue scale (VAS).

Results:A total of 60 patients were included in the study.There was no significant difference in the pre-and post-operatively scores between both groups. The treatment group experienced a significant reduction in post-operative morphine requirements, with 80% of patients who did not receive dexamethasone requiring post-operative morphine compared to only 53.3% of patients who did (p = 0.027).

Conclusions:Pre-operative intravenous administration of a single dose of dexamethasone may decrease opioid requirements for adequate pain control after knee arthroscopy.