Cigada M, Lenzi V, Sherif Afifi M, Esposito B, Burnett J S, Camporesi M
Department of Anesthesiology, SUNY Health Science Center, Syracuse.
Minerva Anestesiol. 1992 Dec;58(12):1323-30.
The efficacy of postoperative pain control with two doses of transdermal fentanyl were compared to a fixed-interval intramuscular (i.m.) morphine regimen in 21 patients undergoing orthopedic surgical procedures. The two transdermal fentanyl patches with delivery rates of 70-80 micrograms/hr and 90-100 micrograms/hr, groups one and two, respectively, were compared to an i.m. morphine regimen of 150 micrograms/kg every 6h, group three. Transdermal patches were applied one hour prior to surgery and removed after 24h. Analgesia, safety scores, side effects, and a global postoperative evaluation were recorded by a blinded physician at frequent intervals up to 36h. No significant difference in pain intensity, evaluated by the visual analog scale, were found between the three groups. Group two had the lowest discomfort score. Groups one and two had a significantly lower respiratory rate than group three. Although there were isolated significant differences in peripheral hemoglobin saturations, these differences were not consistent. This is the first study in which transdermal fentanyl was compared to a fixed-interval i.m. morphine protocol without supplementation with other narcotics. The results show that fentanyl by a transdermal route can provide analgesia comparable to i.m. morphine. No clinically important adverse side effects were found in any of the study groups.
在21例接受骨科手术的患者中，比较了两种剂量的透皮芬太尼与固定间隔肌内注射吗啡方案用于术后疼痛控制的效果。将两组分别为每小时释放速率70 - 80微克和90 - 100微克的透皮芬太尼贴剂，与每6小时注射150微克/千克吗啡的肌内注射方案（第三组）进行比较。透皮贴剂在手术前1小时应用，24小时后取下。由一名不知情的医生在长达36小时的时间内定期记录镇痛效果、安全评分、副作用及术后整体评估情况。通过视觉模拟量表评估，三组之间在疼痛强度方面未发现显著差异。第二组的不适评分最低。第一组和第二组的呼吸频率明显低于第三组。虽然外周血红蛋白饱和度存在个别显著差异，但这些差异并不一致。这是第一项将透皮芬太尼与不补充其他麻醉剂的固定间隔肌内注射吗啡方案进行比较的研究。结果表明，透皮途径给予芬太尼可提供与肌内注射吗啡相当的镇痛效果。在任何研究组中均未发现具有临床重要意义的不良副作用。
