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鞘内注射芬太尼与鞘内注射吗啡对择期全膝关节置换术疼痛影响的比较

Comparison of the Effects of Intrathecal Fentanyl and Intrathecal Morphine on Pain in Elective Total Knee Replacement Surgery.

作者信息

Kılıçkaya Refika, Orak Yavuz, Balcı Mehtap Arda, Balcı Fatih, Ünal İlker

机构信息

Anesthesiology and Reanimation Clinic, Bor State Hospital, Niğde, Turkey.

Anesthesiology and Reanimation Clinic, Mardin State Hospital, Mardin, Turkey.

出版信息

Pain Res Manag. 2016;2016:3256583. doi: 10.1155/2016/3256583. Epub 2016 Dec 27.

Abstract

. Total knee replacement is one of the most painful orthopedic surgical procedures. In this study, our goal was to compare the intraoperative and postoperative hemodynamic effects, the side effects, the effect on the duration of pain start, the 24-hour VAS, and the amount of additional analgesia used, of the fentanyl and morphine we added to the local anesthetic in the spinal anesthesia we administered in cases of elective knee replacement. . After obtaining the approval of the Erciyes University Medical Faculty Clinical Drug Trials Ethics Committee, as well as the verbal and written consent of the patients, we included 50 patients in our prospective, randomized study. . In our study, the morphine group (Group M) had lower pain scores in the 2nd, 6th, 12th, and 24th hours compared to the fentanyl group (Group F). When additional analgesic requirements were compared, it was found that in the 2nd, 6th, and 24th hours fewer Group M patients needed more analgesics than did Group F patients. . The fentanyl group also had lower first analgesic requirement times than did the morphine group. In terms of nausea and vomiting, there was no statistically significant difference between the two groups.

摘要

全膝关节置换术是最疼痛的骨科手术之一。在本研究中,我们的目标是比较在择期膝关节置换术病例中,我们在脊髓麻醉的局部麻醉剂中添加的芬太尼和吗啡的术中及术后血流动力学效应、副作用、对疼痛开始持续时间的影响、24小时视觉模拟评分(VAS)以及额外使用的镇痛药量。在获得埃尔西耶斯大学医学院临床试验伦理委员会的批准以及患者的口头和书面同意后,我们将50名患者纳入了前瞻性随机研究。在我们的研究中,与芬太尼组(F组)相比,吗啡组(M组)在第2、6、12和24小时的疼痛评分更低。当比较额外镇痛需求时,发现第2、6和24小时需要更多镇痛药的M组患者比F组患者少。芬太尼组的首次镇痛需求时间也比吗啡组短。在恶心和呕吐方面,两组之间没有统计学上的显著差异。

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