Kenady D E, Wilson J F, Schwartz R W, Bannon C L, Wermeling D
Department of Surgery, University of Kentucky, Lexington.
Surg Gynecol Obstet. 1992 Mar;174(3):216-20.
In the current study, 55 patients undergoing elective cholecystectomy were randomly allocated to receive postoperative analgesia (morphine sulfate) administered through either patient-controlled intravenous (PCA) or standard intramuscular (IM) routes. There were no significant differences in length of hospitalization or required dose of morphine sulfate. Patients randomized to PCA reported significantly improved subjective relief from pain and a smaller percentage of time in pain during each of the first two postoperative days. In addition, they reported less sedation and less interference with both postoperative breathing and pulmonary recovery than patients who received IM morphine. Theoretically, PCA regimens can deliver narcotic analgesia at a higher and more varied rate (with fewer side effects) compared with standard IM narcotic delivery, which is more limited by considerations of clinical doses. In PCA dosing, patients should experience less time in pain and sedation. The results of the current study support this premise.
在本研究中，55例行择期胆囊切除术的患者被随机分配，分别接受通过患者自控静脉镇痛（PCA）或标准肌内注射（IM）途径给予的术后镇痛（硫酸吗啡）。住院时间或硫酸吗啡所需剂量方面无显著差异。随机分配至PCA组的患者在前两个术后日的每一天均报告主观疼痛缓解显著改善，且疼痛时间百分比更低。此外，与接受肌内注射吗啡的患者相比，他们报告的镇静作用较轻，对术后呼吸和肺部恢复的干扰也较小。从理论上讲，与标准肌内注射麻醉给药相比，PCA方案可以更高且更多样化的速率提供麻醉镇痛（副作用更少），而标准肌内注射麻醉给药在临床剂量方面受到更多限制。在PCA给药中，患者的疼痛和镇静时间应更短。本研究结果支持这一前提。
