硫酸吗啡硬膜外浸润后腰椎融合术的术后即刻疼痛程度
Immediate postoperative pain level from lumbar arthrodesis following epidural infiltration of morphine sulfate.
作者信息
Amaral Carlos Alexandre Botelho do, Vieira Tertuliano, Nakagawa Edgar Taira, Losch Eduardo Aires, Labronici Pedro José
机构信息
Prof. Dr. Donato D'Ângelo Orthopedics and Traumatology Service, Hospital Santa Teresa, Petrópolis, RJ, Brazil.
出版信息
Rev Bras Ortop. 2015 Feb 19;50(1):72-6. doi: 10.1016/j.rboe.2015.02.005. eCollection 2015 Jan-Feb.
OBJECTIVE
To evaluate the pain level in patients treated with epidural infusion of morphine sulfate in a single dose, after a surgical procedure to perform lumber arthrodesis.
METHODS
Forty patients underwent posterolateral lumbar arthrodesis or intersomatic lumbar arthrodesis via a posterior route at one, two or three levels. They were prospectively randomized into two groups of 20. In the first group (study group), 2 mg of morphine sulfate diluted in 10 mL of physiological serum was infiltrated into the epidural space, through the laminectomy area. The second group (controls) did not receive analgesia. The patients were asked about their pain levels before and after the operation, using a visual analog scale (VAS).
RESULTS
It was found that the patients presented a significant diminution of pain as shown by the VAS. From before to after the operation, it decreased by an average of 4.7 points (p = 0.0001), which corresponded to 53.2% (p = 0.0001).
CONCLUSION
Application of 2 mg of morphine sulfate in a single epidural dose was shown to be a good technique for pain therapy following lumbar spinal surgery.
目的
评估在进行腰椎融合手术的患者中，单次硬膜外输注硫酸吗啡后的疼痛程度。
方法
40例患者接受了单节段、双节段或三节段后外侧腰椎融合术或后路腰椎椎间融合术。他们被前瞻性地随机分为两组，每组20例。第一组（研究组）将2mg硫酸吗啡稀释于10mL生理盐水中，通过椎板切除区域注入硬膜外间隙。第二组（对照组）未接受镇痛治疗。使用视觉模拟评分法（VAS）询问患者手术前后的疼痛程度。
结果
发现患者的VAS评分显示疼痛显著减轻。从手术前到手术后，平均下降了4.7分（p = 0.0001），相当于下降了53.2%（p = 0.0001）。
结论
单次硬膜外注射2mg硫酸吗啡被证明是腰椎手术后疼痛治疗的一种良好技术。
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