Department of Anaesthesiology and Reanimation, Ege University School of Medicine, Izmir, Turkey.
Eur Rev Med Pharmacol Sci. 2013 Mar;17(6):834-8.
Intrathecal (IT) morphine provides prolonged analgesia after major surgery.
The aim of our study was to assess the impact of intrathecal morphine 200 µg on patient-controlled analgesia (PCA) tramadol consumptions and postoperative pain in patients who underwent radical retropubic prostatectomy (RRP) under general anesthesia.
In this prospective trial, 56 men who underwent radical retropubic prostatectomy (RRP) were randomized into 2 groups. Group M received intrathecal morphine (200 µg) before the induction of general anesthesia. Group C did not receive intrathecal morphine. Postoperative analgesia was provided with tramadol PCA. Pain scores, tramadol consumption, adverse effects, rescue analgesia were recorded.
Total tramadol consumption at 24 hours and pain scores during 12 hours postoperatively were significantly lower in Group M compared with Group C (p < 0.05). Rescue analgesia and postoperative nausea were lower in Group M than in Group C (p < 0.05).
Intrathecal morphine 200 µg provided a significant reduction in tramadol consumption, postoperative pain scores, rescue analgesia, and postoperative nausea after RRP without serious adverse effects.
鞘内（IT）吗啡可在大手术后提供长时间的镇痛作用。
本研究旨在评估全身麻醉下接受根治性前列腺切除术（RRP）的患者鞘内注射 200μg 吗啡对患者自控镇痛（PCA）曲马多消耗和术后疼痛的影响。
在这项前瞻性试验中，56 名接受根治性前列腺切除术（RRP）的男性患者被随机分为 2 组。M 组在全身麻醉诱导前接受鞘内注射吗啡（200μg）。C 组未接受鞘内注射吗啡。术后采用曲马多 PCA 进行镇痛。记录疼痛评分、曲马多消耗、不良反应和解救性镇痛。
与 C 组相比，M 组在术后 24 小时的总曲马多消耗量和术后 12 小时的疼痛评分显著降低（p<0.05）。M 组的解救性镇痛和术后恶心发生率低于 C 组（p<0.05）。
鞘内注射 200μg 吗啡可显著减少 RRP 后曲马多的消耗、术后疼痛评分、解救性镇痛和术后恶心，且无严重不良反应。
