Larijani Ghassem E, Goldberg Michael E, Gratz Irwin, Warshal David P
Department of Anesthesiology, Cooper University Hospital, University of Medicine and Dentistry of New Jersey, Camden, New Jersey, USA.
Pharmacotherapy. 2004 Dec;24(12):1675-80. doi: 10.1592/phco.24.17.1675.52335.
To evaluate the analgesic and hemodynamic effects of a single dose of intravenous morphine 7.5 mg in patients experiencing moderate-to-severe postoperative pain, and to determine any gender differences in analgesic response.
Randomized, double-blind, parallel-group, multicenter study.
Postanesthesia care unit of a university teaching hospital.
Eighty-eight patients who underwent total abdominal hysterectomy or prostatectomy.
Thirty-seven patients received a single dose of morphine sulfate 7.5 mg and 51 patients received placebo, both administered intravenously for 1 minute.
Overall, morphine had no significant effect on systolic or diastolic blood pressure, heart rate, oxygen saturation, or respiratory rate. Compared with baseline, morphine significantly reduced pain intensity at 2, 5, and 10 minutes after administration (p<0.05). The difference in pain intensity between patients who received morphine and those who received placebo, however, was significant only at the 5-minute time point (p<0.02). Patients receiving morphine also reported mild pain relief at 2 and 5 minutes after its administration. Peak analgesic effect was reported 2 minutes after its administration in three quarters of the patients. Significant gender differences also were observed in response to analgesic effect. In women, no significant differences in pain intensity were seen at any time between the morphine and placebo groups, whereas in men receiving morphine, pain intensity was significantly less at 2, 5, and 10 minutes compared with baseline and that seen in the placebo group. Women were generally more satisfied with their pain treatment than were men.
A single 7.5-mg intravenous bolus dose of morphine did not appear to provide adequate reduction in perceived pain intensity in patients with moderate-to-severe postoperative pain. In addition, in contrast to the findings of other experimental pain studies, our data suggest that women are more tolerant of postoperative pain than are men.
评估单剂量静脉注射7.5毫克吗啡对中重度术后疼痛患者的镇痛及血流动力学影响，并确定镇痛反应中是否存在性别差异。
随机、双盲、平行组、多中心研究。
大学教学医院的麻醉后护理单元。
88例行全腹子宫切除术或前列腺切除术的患者。
37例患者接受单剂量7.5毫克硫酸吗啡，51例患者接受安慰剂，均静脉注射1分钟。
总体而言，吗啡对收缩压、舒张压、心率、血氧饱和度或呼吸频率无显著影响。与基线相比，吗啡在给药后2、5和10分钟时显著降低疼痛强度（p<0.05）。然而，接受吗啡的患者与接受安慰剂的患者之间的疼痛强度差异仅在5分钟时间点显著（p<0.02）。接受吗啡的患者在给药后2和5分钟时也报告有轻度疼痛缓解。四分之三的患者在给药后2分钟报告达到最大镇痛效果。在镇痛效果反应方面也观察到显著的性别差异。在女性中，吗啡组和安慰剂组在任何时间的疼痛强度均无显著差异，而在接受吗啡的男性中，与基线及安慰剂组相比，在2、5和10分钟时疼痛强度显著更低。女性对疼痛治疗的总体满意度通常高于男性。
单剂量静脉推注7.5毫克吗啡似乎未能充分降低中重度术后疼痛患者的疼痛强度。此外，与其他实验性疼痛研究的结果相反，我们的数据表明女性比男性对术后疼痛更耐受。
