Bigat Z, Hadimioglu N, Ertug Z, Boztug N, Erdogan O, Demirbas A
Department of Anesthesiology and ICU, Akdeniz University, Medical Faculty, Antalya, Turkey.
Transplant Proc. 2006 Mar;38(2):392-5. doi: 10.1016/j.transproceed.2005.12.103.
To provide postoperative analgesia by spinal anesthesia, we compared the quality of analgesia and side effects of two doses of morphine added to ropivacaine in kidney donors.
Thirty renal donors underwent nephrectomy under standard general anesthesia. After the operation, the patients were randomly allocated into two groups of intrathecal doses for spinal anesthesia: the 0.5 group (n = 15) received a total volume of 4 mL including 0.5 mg morphine, 10 mg ropivacaine, and 0.9% NaCl, and the 0.3 group (n = 15), a total volume of 4 mL including 0.3 mg morphine, 10 mg ropivacaine, and 0.9% NaCl. After extubation, an intravenous (IV) morphine protocol was initiated by a patient-controlled analgesia pump to provide sufficient spinal analgesia.
In the 0.3 group, the IV morphine consumption was significantly higher, namely, 14.60 +/- 7.57 times versus 4.60 +/- 10.14 times for the 0.5 group (P = .005). The total amount of morphine was 7.80 +/- 5.40 mg in the 0.5 group and 13.53 +/- 5.30 mg in the 0.3 group (P < .05). Postoperative side effects of nausea and vomiting were higher among the 0.3 group (P < .05).
In the 0.5 group, the quality of analgesia was better than in the 0.3 group. The need for IV morphine was less in the 0.5 group. Also, side effects like nausea and vomiting were less, so better analgesia in the postoperative period was obtained with the 0.5 mg morphine solution.
为通过脊髓麻醉提供术后镇痛，我们比较了肾供体中添加到罗哌卡因中的两种剂量吗啡的镇痛质量和副作用。
30例肾供体在标准全身麻醉下接受肾切除术。术后，患者被随机分为两组进行脊髓麻醉鞘内给药剂量：0.5组（n = 15）接受总量为4 mL的溶液，其中包括0.5 mg吗啡、10 mg罗哌卡因和0.9%氯化钠，0.3组（n = 15）接受总量为4 mL的溶液，其中包括0.3 mg吗啡、10 mg罗哌卡因和0.9%氯化钠。拔管后，通过患者自控镇痛泵启动静脉注射吗啡方案以提供足够的脊髓镇痛。
在0.3组中，静脉注射吗啡的消耗量显著更高，0.5组为4.60±10.14次，而0.3组为14.60±7.57次（P = 0.005）。0.5组吗啡总量为7.80±5.40 mg，0.3组为13.53±5.30 mg（P < 0.05）。0.3组术后恶心和呕吐的副作用更高（P < 0.05）。
在0.5组中，镇痛质量优于0.3组。0.5组对静脉注射吗啡的需求更少。此外，恶心和呕吐等副作用更少，因此0.5 mg吗啡溶液在术后获得了更好的镇痛效果。
