Karamese Mehtap, Akdağ Osman, Kara İnci, Yıldıran Gokce Unal, Tosun Zekeriya
Department of Plastic Reconstructive and Aesthetic Surgery, Selcuk University, Konya, Turkey.
Department of Anesthesiology and Reanimation, Selcuk University, Konya, Turkey.
Eplasty. 2015 May 5;15:e15. eCollection 2015.
Following breast reduction procedures, the level of postoperative pain can be severe, and sufficient pain control influences a patient's physiological, immunological, and psychological status.
The aim of this study was to examine the use of intrathecal morphine (ITM) in breast reduction surgery with patient-controlled analgesia (PCA).
Sixty-two female patients who underwent breast reductions with the same technique participated in this study. The study group (ITM + PCA) included 32 patients; a single shot (0.2 mg) of ITM and intravenous morphine with PCA were administered. In the control group, morphine PCA alone was intravenously administered to 30 patients. Comparisons between the groups of cumulative morphine consumption, visual analog scale scores, and patient satisfaction scores, which were the primary outcome measures, and adverse effects, which were the secondary outcome measures, were conducted.
The patients in the 2 groups had similar degrees of pain and satisfaction scores. The study group had lower cumulative morphine consumption (P = .001) than the PCA-only control group; there was no statistically significant difference in adverse effects between the 2 groups.
Intrathecal morphine may effectively control pain with lower total morphine consumption following breast reduction surgery.
乳房缩小手术后，术后疼痛程度可能很严重，充分的疼痛控制会影响患者的生理、免疫和心理状态。
本研究的目的是探讨鞘内注射吗啡（ITM）在乳房缩小手术中联合患者自控镇痛（PCA）的应用。
62例采用相同技术进行乳房缩小手术的女性患者参与了本研究。研究组（ITM + PCA）包括32例患者；给予单次鞘内注射吗啡（0.2 mg）及静脉注射吗啡联合PCA。对照组30例患者仅静脉给予吗啡PCA。对两组间作为主要结局指标的累积吗啡消耗量、视觉模拟量表评分和患者满意度评分，以及作为次要结局指标的不良反应进行比较。
两组患者的疼痛程度和满意度评分相似。研究组的累积吗啡消耗量低于仅使用PCA的对照组（P = .001）；两组间不良反应无统计学显著差异。
鞘内注射吗啡可有效控制乳房缩小手术后的疼痛，且总吗啡消耗量更低。
