Lisowska Barbara, Cwiek Renata, Małdyk Paweł, Hofmeister Anita, Luboiński Piotr
Klinika Reumoortopedii, Instytut Reumatologii im. prof dr hab. med. Eleonory Reicher.
Chir Narzadow Ruchu Ortop Pol. 2007 Jan-Feb;72(1):55-60.
The aim of this study was to evaluate the analgesic efficacy and side effects of intrathecal morphine in the dose range 0.2-0.5 mg. One-hundred patients scheduled for elective lower limb orthopedic operation under spinal anesthesia using hyperbaric or isobaric bupivacaine 0.5% with morphine in dose from 0.2 to 0.5 mg. Pain score, duration of analgesia and the incidence of adverse effects like nausea, vomiting, pruritus, urinary retention and respiratory depression were assessed for 48 hr postoperatively. There were significant differences in the duration and efficacy analgesia and the incidence of pruritus the morphine dose-related. We did not observe the increased frequency of nausea and vomiting with increased dose. The respiratory depression not observed in connection with intrathecal morphine. The evidence from this current study suggests that spinal anesthesia with combination of local anesthetic and morphine can be employed to provide safe and efficacious analgesia in patients undergoing orthopedic operations. The adverse effects which developed due to intrathecal morphine were able to treat with success.
本研究的目的是评估鞘内注射0.2 - 0.5毫克吗啡的镇痛效果和副作用。100例计划在脊髓麻醉下进行择期下肢骨科手术的患者，使用0.5%的重比重或等比重布比卡因加0.2至0.5毫克吗啡。术后48小时评估疼痛评分、镇痛持续时间以及恶心、呕吐、瘙痒、尿潴留和呼吸抑制等不良反应的发生率。镇痛持续时间、效果以及瘙痒发生率与吗啡剂量相关，存在显著差异。我们未观察到随着剂量增加恶心和呕吐频率增加。未观察到与鞘内注射吗啡相关的呼吸抑制。当前这项研究的证据表明，局部麻醉药与吗啡联合用于脊髓麻醉可为接受骨科手术的患者提供安全有效的镇痛。鞘内注射吗啡引起的不良反应能够成功治疗。
