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인공 슬관절 치환술 후 활액막내에 주입한 Ropivacaine과 Morphine이 수술 후 통증에 미치는 영향: 전향적 연구

Other Titles
 The Effects of Intra synovial Ropivacaine and Morphine Injection on Postoperative Pain After Total Knee Arthroplasty 
Authors
 한창동  ;  최윤진  ;  양익환 
Citation
 Journal of Korean Knee Society (대한슬관절학회지), Vol.18(2) : 158-166, 2006 
Journal Title
 Journal of Korean Knee Society (대한슬관절학회지) 
ISSN
 1225-1623 
Issue Date
2006
Keywords
Ropivacaine ; Morphine
Abstract
Purpose: Pain control after total knee arthroplasty reduces total admission days and is important in improving post operative range of motion. This study evaluates the efficacy of intrasynovial injection of morphine and ropivacaine after total knee arthroplasty. Materials and Methods: A prospective, double blinded and randomized study was performed in thirty two patients with American society of anesthesiology stage I or II who underwent one staged total knee arthroplasty for both knees simultaneously under spinal anesthesia. Demographic data (age, height, weight, gender distribution, Hospital for Special Surgery knee score, Knee society score, visual analogue scores (VAS) and range of motion were evaluated in all patients preoperatively. Before closure of the joint capsule, a local injective analgesia of 50mL including 0.5 ml 5 mg of HCL morphine, 40 mL 0.6% 300 mg ropivacaine and 0.25 mL of 1:200,000 epinephrine was injected into the synovium of one knee and 50 mL of normal saline was injected into the synovium of the opposite knee. Analgesic efficacy was evaluated by visual analogue scores (VAS) at intervals of 2, 4, 6, 12, 24, 32, 40 and 48 hours after operation. During this period, the amount of postoperative bleeding and range of motion were compared between both knees in the same patient. Results: There were no statistically significant differences among both knees in regard to VAS at intervals of 2, 4, 6, 12, 24, 32, 40 and 48 hours after surgery (p>0.05). There were no statistically significant differences between the range of motion among both knees (p>0.05). Conclusion: On the basis of the results of this study, we do not recommend the routine use of postoperative intrasynovial ropivacaine and morphine injection for the purpose of reducing pain in patients undergoing knee arthroplasty under spinal anesthesia with epidural patient controlled anesthesia.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Yang, Ick Hwan(양익환)
Han, Chang Dong(한창동)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/110081
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