Eandi J A, de Vere White R W, Tunuguntla H S G R, Bohringer C H, Evans C P
Department of Urology and Department of Anesthesiology, UC Davis Medical Center, Sacramento, California 95817, USA.
Prostate Cancer Prostatic Dis. 2002;5(3):226-30. doi: 10.1038/sj.pcan.4500584.
We retrospectively analyzed the analgesic efficacy and surgical outcomes of a single preoperative intrathecal long-acting morphine sulfate injection (0.25-0.5 mg) and postoperative intravenous (i.v.) ketorolac in 62 patients who underwent radical retropubic prostatectomy (RRP). Total postoperative analgesic requirement was documented along with assessment of length of hospital stay, pain control and time for resumption of normal activity. Postoperatively, 45% of patients required only nonsteroidal agents (ketorolac), whereas 55% needed a mean of 13.3 mg of supplemental i.v. morphine sulfate. Mean hospital stay was 2.3+/-0.3 days. Eighty-two per cent of patients felt the length of hospital stay adequate. Ninety-seven per cent of patients were satisfied with anesthesia selected and 95% of patients considered pain control on postoperative days 1 and 2 as effective. All patients resumed to full physical activity by 5.3+/-0.4 weeks after surgery. We conclude that a single preoperative injection of intrathecal morphine sulfate combined with i.v. ketorolac postoperatively results in effective analgesia, diminished supplemental narcotic requirement and high patient satisfaction during radical retropubic prostatectomy.
我们回顾性分析了62例行耻骨后根治性前列腺切除术（RRP）患者术前单次鞘内注射长效硫酸吗啡（0.25 - 0.5毫克）及术后静脉注射酮咯酸的镇痛效果和手术结果。记录术后总的镇痛需求，同时评估住院时间、疼痛控制情况以及恢复正常活动的时间。术后，45%的患者仅需非甾体类药物（酮咯酸），而55%的患者平均需要补充13.3毫克静脉注射硫酸吗啡。平均住院时间为2.3±0.3天。82%的患者认为住院时间合适。97%的患者对所选麻醉满意，95%的患者认为术后第1天和第2天的疼痛控制有效。所有患者在术后5.3±0.4周恢复完全体力活动。我们得出结论，术前单次鞘内注射硫酸吗啡联合术后静脉注射酮咯酸在耻骨后根治性前列腺切除术中可产生有效的镇痛效果，减少补充麻醉剂的需求，并提高患者满意度。
