Bailey P M, Sangwan S
Anaesthesia. 1986 May;41(5):499-504. doi: 10.1111/j.1365-2044.1986.tb13274.x.
Seventy-three patients undergoing elective perianal surgery were randomly divided into a control group, a group who received a caudal injection of 20 ml bupivacaine 0.5% plain and a group who received diamorphine 2.5 mg in 10 ml normal saline by caudal injection; a comparison was then made of postoperative analgesia requirements. The bupivacaine group had better analgesia than the control group for the first 8 hours, after which there was no difference. The diamorphine group had better analgesia than the control group for the first 24 hours postoperatively. Side effects were less in the diamorphine group than the control, or the bupivacaine group. In particular, 41% of the bupivacaine group complained of some degree of urinary retention and one patient required temporary catheterisation. It is concluded that caudal diamorphine gives good postoperative analgesia for perianal operations, particularly when motor blockade is not wanted by the surgeon.
73例接受择期肛周手术的患者被随机分为对照组、尾骶部注射20毫升0.5%布比卡因原液的组以及尾骶部注射10毫升生理盐水中含2.5毫克二氢吗啡酮的组；随后对术后镇痛需求进行比较。布比卡因组在术后前8小时的镇痛效果优于对照组，之后则无差异。二氢吗啡酮组在术后24小时内的镇痛效果优于对照组。二氢吗啡酮组的副作用比对照组或布比卡因组少。特别是，布比卡因组41%的患者主诉有一定程度的尿潴留，1例患者需要临时导尿。结论是，尾骶部注射二氢吗啡酮可为肛周手术提供良好的术后镇痛效果，尤其是在外科医生不需要运动阻滞的情况下。
