Kara I, Apiliogullari S, Oc B, Celik J B, Duman A, Celik C, Dogan N U
Department of Anaesthesia and Intensive Care, Selcuklu Medical Faculty, Selcuk University, 42075 Selcuklu, Konya, Turkey.
J Int Med Res. 2012;40(2):666-72. doi: 10.1177/147323001204000229.
Gynaecological oncological surgery (GOS) includes a wide variety of surgical procedures and postoperative pain is a major concern. This study compared the impact of intrathecal morphine (ITM) plus patient-controlled analgesia (PCA) with PCA alone on morphine consumption, pain relief and patient satisfaction after GOS.
Sixty women undergoing GOS under general anaesthesia were randomized to receive either 0.3 mg ITM or placebo. On arrival at the postanaesthesia care unit each patient received a morphine PCA pump. The three primary outcome measures were pain, patient satisfaction scores evaluated using a 100-mm visual analogue scale and cumulative PCA morphine consumption.
No significant differences were observed in the demographic data. Cumulative PCA morphine consumption was significantly lower in the ITM group compared with the control group. Fatigue scores were lower in the ITM group compared with the control group but did not reach statistical significance. Pain, sedation and patient satisfaction scores, and the rate of side-effects were similar for the two groups.
Administering ITM in GOS could improve postoperative analgesia and reduce morphine consumption without serious side-effects.
妇科肿瘤手术（GOS）包含多种外科手术操作，术后疼痛是一个主要问题。本研究比较了鞘内注射吗啡（ITM）联合患者自控镇痛（PCA）与单纯PCA对GOS术后吗啡用量、疼痛缓解及患者满意度的影响。
60例在全身麻醉下接受GOS的女性被随机分为两组，分别接受0.3 mg ITM或安慰剂。到达麻醉后护理单元时，每位患者均接受一个吗啡PCA泵。三个主要观察指标为疼痛、使用100 mm视觉模拟量表评估的患者满意度评分以及PCA吗啡累计用量。
两组患者的人口统计学数据无显著差异。与对照组相比，ITM组的PCA吗啡累计用量显著更低。与对照组相比，ITM组的疲劳评分更低，但未达到统计学显著性。两组的疼痛、镇静及患者满意度评分以及副作用发生率相似。
在GOS中给予ITM可改善术后镇痛并减少吗啡用量，且无严重副作用。
