Machida Masafumi, Imamura Yasuhide, Usui Takeo, Asai Tohru
Department of Orthopaedic Surgery, National Murayama Hospital, Tokyo, Japan.
J Pediatr Orthop. 2004 Sep-Oct;24(5):576-80. doi: 10.1097/00004694-200409000-00021.
The authors evaluated prospectively the efficacy and safety of continuous subcutaneous morphine administration for postoperative analgesia after posterior spinal fusion and instrumentation for idiopathic scoliosis. Thirty patients were given the subcutaneous morphine infusion (20 mg/day), and 20 patients were not given morphine (control group). Postoperative pain control was assessed using a verbal response score (VRS) and a visual analog pain scale (VAS). The number of times the patient requested supplemental analgesics was also evaluated. VRS and VAS measurements were significantly lower in the continuous subcutaneous morphine group compared with the control group. Also, analgesic consumption in the continuous subcutaneous morphine group was lower than that of the control group. There was no respiratory depression or constipation. Preemptive analgesia using continuous subcutaneous infusion of morphine is a simple, safe, and effective method to control postoperative pain after posterior instrumentation and spinal fusion for idiopathic scoliosis.
作者前瞻性地评估了持续皮下注射吗啡用于特发性脊柱侧弯后路脊柱融合及器械固定术后镇痛的有效性和安全性。30例患者接受皮下吗啡输注(20毫克/天),20例患者未使用吗啡(对照组)。使用语言反应评分(VRS)和视觉模拟疼痛量表(VAS)评估术后疼痛控制情况。还评估了患者要求补充镇痛药的次数。与对照组相比,持续皮下注射吗啡组的VRS和VAS测量值显著更低。此外,持续皮下注射吗啡组的镇痛药消耗量低于对照组。未出现呼吸抑制或便秘情况。采用持续皮下输注吗啡进行超前镇痛是控制特发性脊柱侧弯后路器械固定及脊柱融合术后疼痛的一种简单、安全且有效的方法。