Kong S-K, Onsiong S M K, Chiu W K Y, Li M K W
Department of Anaesthesiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Anaesthesia. 2002 Dec;57(12):1168-73. doi: 10.1046/j.1365-2044.2002.02873.x.
Laparoscopic surgery has become popular in recent years, but few studies have addressed analgesia for this type of surgery. We conducted a prospective double-blind randomised trial on 36 cases of laparoscopic colorectal surgery to determine the influence of intrathecal morphine on postoperative pain relief. All patients received a subarachnoid block with local anaesthetic in addition to general anaesthesia. One group also received intrathecal morphine. A patient-controlled analgesic (PCA) device was prescribed for pain control postoperatively and the visual analogue score (VAS) was used for pain assessment. The group who received intrathecal morphine used significantly less morphine. There were no adverse cardiovascular effects of the combined anaesthetic technique. Nausea and vomiting remained the main side-effect of intrathecal morphine but this was easily treated with anti-emetics.
近年来，腹腔镜手术已变得很普遍，但针对此类手术的镇痛研究却很少。我们对36例腹腔镜结直肠手术患者进行了一项前瞻性双盲随机试验，以确定鞘内注射吗啡对术后疼痛缓解的影响。所有患者除接受全身麻醉外，还接受了局部麻醉药的蛛网膜下腔阻滞。其中一组还接受了鞘内注射吗啡。术后使用患者自控镇痛（PCA）装置控制疼痛，并采用视觉模拟评分（VAS）进行疼痛评估。接受鞘内注射吗啡的组使用的吗啡明显较少。联合麻醉技术未产生不良心血管影响。恶心和呕吐仍是鞘内注射吗啡的主要副作用，但使用止吐药很容易治疗。
