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[上腹部手术后持续静脉输注哌替啶镇痛:与持续硬膜外输注哌替啶的随机、前瞻性双盲比较]

[Continuous intravenous pethidine infusion for analgesia after upper abdominal surgery: a randomized, prospective double-blind comparison with continuous epidural infusion of pethidine].

作者信息

Mitsuhata H, Matsumoto S, Hasegawa J, Ohtaka K

机构信息

Department of Anesthesiology, Hiraka General Hospital, Yokote.

出版信息

Masui. 1991 Dec;40(12):1770-6.

PMID:1770568
Abstract

We conducted a randomized double-blind controlled study comparing patients receiving continuous intravenous pethidine infusion with those receiving continuous epidural infusion for postoperative analgesia after upper abdominal surgery. Twenty patients scheduled for upper abdominal surgery were randomized into 2 groups: IV Group (n = 10) received 100 mg.24 h-1 of pethidine intravenously and saline epidurally, Epi Group (n = 10) received 100 mg.24 h-1 of pethidine epidurally and saline intravenously. During 24-hour postoperatively, verbal descriptor pain scale, sedative scale, respiratory rate, pulse rate and blood pressure were evaluated at each 2 hours. During 72-hour postoperatively, visual analogue pain scale (added at 6-hour postoperatively), supplemental doses of pethidine, and side effects were evaluated at each period of 12 hours. There was no significant difference in the rating of analgesia in either group during 72-hour postoperatively. However in the first 12 hours postoperatively, VAS in Epi Group tended to be lower than that in IV Group. There was no respiratory depression in either group. We conclude that continuous intravenous infusion of 100 mg.24h-1 of pethidine was effective for postoperative analgesia after upper abdominal surgery without major side effects, and almost the same analgesic effect was obtained as compared with continuous epidural analgesia.

摘要

我们进行了一项随机双盲对照研究,比较上腹部手术后接受连续静脉注射哌替啶与接受连续硬膜外输注用于术后镇痛的患者。20例计划行上腹部手术的患者被随机分为2组:静脉组(n = 10)静脉注射100mg.24h-1哌替啶并硬膜外注射生理盐水,硬膜外组(n = 10)硬膜外注射100mg.24h-1哌替啶并静脉注射生理盐水。术后24小时内,每2小时评估言语描述疼痛量表、镇静量表、呼吸频率、脉搏率和血压。术后72小时内,每12小时评估视觉模拟疼痛量表(术后6小时增加)、哌替啶补充剂量和副作用。术后72小时内两组镇痛评分无显著差异。然而,术后前12小时,硬膜外组的视觉模拟评分倾向于低于静脉组。两组均无呼吸抑制。我们得出结论,连续静脉输注100mg.24h-1哌替啶对上腹部手术后的术后镇痛有效,且无主要副作用,与连续硬膜外镇痛相比,镇痛效果几乎相同。

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