• 四川大學(xué)華西醫(yī)院麻醉科（成都 610041）;

目的 　研究膝關(guān)節(jié)腔內(nèi)聯(lián)合應(yīng)用羅哌卡因與利多卡因的鎮(zhèn)痛效果。
方法 　采用隨機(jī)雙盲安慰劑對(duì)照的試驗(yàn)方法，將90例膝關(guān)節(jié)鏡手術(shù)患者分為3組，每組分別在術(shù)畢膝關(guān)節(jié)腔內(nèi)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(jìn)行鎮(zhèn)痛評(píng)估，記錄術(shù)后補(bǔ)救性鎮(zhèn)痛藥總用量。
結(jié)果 　R組術(shù)后2h休息時(shí)、術(shù)后1~8h運(yùn)動(dòng)時(shí)的視覺模擬評(píng)分(VAS評(píng)分)明顯低于NS組（P  lt;0.05）。RL組術(shù)后0.5～2h休息時(shí)及術(shù)后清醒至術(shù)后24 h運(yùn)動(dòng)時(shí)的VAS評(píng)分明顯低于NS組（P  lt;0.05）。
結(jié)論 　膝關(guān)節(jié)腔內(nèi)注射羅哌卡因能明顯減輕患者術(shù)后疼痛程度。羅哌卡因+利多卡因關(guān)節(jié)腔內(nèi)注射能減輕患者術(shù)后清醒即刻的疼痛程度，達(dá)到術(shù)后早期鎮(zhèn)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(lián)合用于膝關(guān)節(jié)鏡術(shù)后鎮(zhèn)痛的隨機(jī)雙盲安慰劑對(duì)照試驗(yàn). 中國(guó)循證醫(yī)學(xué)雜志, 2006, 06(8): 557-562. doi: 復(fù)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. 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. 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. 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. 4. Franceschi F, Rizzello G, Cataldo R, et al.Comparison of morphine and ropivacaine following knee arthroscopy. Arthroscopy, 2001;17(5):477-480.
  5. 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. 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. 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. 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. 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. 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.