SRM Medical College Hospital and Research Centre, Department of Anaesthesia, Tamilnadu, India.
SRM Medical College Hospital and Research Centre, Department of Anaesthesia, Tamilnadu, India.
Braz J Anesthesiol. 2021 Jul-Aug;71(4):339-344. doi: 10.1016/j.bjane.2020.12.013. Epub 2020 Dec 28.
Post-operative analgesia for Spine surgeries is difficult without patient control analgesia (PCA) and inadequate monitoring facilities. The objective was to study the effectiveness of analgesia of intravenous administration of low dose fentanyl and morphine for postoperative analgesia following spine fusion surgeries.
One hundred adult patients undergoing spine instrumentation surgeries were randomly allotted into two groups: Group M (morphine) or Group F (fentanyl). The patients received either 0.02 mg.kg.h of morphine or 0.3 mcg.kg.h of fentanyl infusion postoperatively. If the patient had pain, additional bolus dose of 0.04 mg.kg and 0.6 mcg. kg bolus for morphine and fentanyl respectively were given and noted. The additional analgesic consumption was recorded. The Ramsay sedation score (RSS), visual analogue score (VAS), vital parameters and complications were observed.
The demographic characteristics did not reveal significant difference among the two groups. In morphine group, 32 patients did not require any additional bolus dose, 15 patients needed one bolus dose and one patient each required two and three boluses. In fentanyl group, two, 24, 20 and four patients required 0, 1, 2 and 3 bolus doses respectively. There were no statistically significant variations in hemodynamic features like heart rate, blood pressure and oxygen saturation, RSS and VAS. The complication rate was not significant among the groups.
Low dose continuous infusion of morphine is more effective than fentanyl with fewer requirements of rescue analgesics for postoperative analgesia. Both drugs are safe without any serious complications.
脊柱手术的术后镇痛，如果没有患者自控镇痛（PCA）和不完善的监测设施，就会很困难。本研究旨在评估静脉给予小剂量芬太尼和吗啡用于脊柱融合术后镇痛的效果。
100 名接受脊柱器械手术的成年患者被随机分为两组：组 M（吗啡）或组 F（芬太尼）。术后患者分别接受 0.02mg/kg/h 的吗啡或 0.3mcg/kg/h 的芬太尼输注。如果患者有疼痛，分别给予 0.04mg/kg 和 0.6mcg/kg 的吗啡和芬太尼追加剂量，并记录。记录额外的镇痛消耗。观察 Ramsay 镇静评分（RSS）、视觉模拟评分（VAS）、生命体征和并发症。
两组患者的人口统计学特征无显著差异。在吗啡组中，32 名患者无需追加剂量，15 名患者需要 1 次追加剂量，1 名患者需要 2 次，1 名患者需要 3 次。在芬太尼组中，2 名、24 名、20 名和 4 名患者分别需要 0、1、2 和 3 次追加剂量。两组患者的心率、血压和血氧饱和度、RSS 和 VAS 等血流动力学特征均无统计学显著差异。各组的并发症发生率无显著差异。
小剂量持续输注吗啡比芬太尼更有效，需要较少的抢救性镇痛药物。两种药物均安全，无严重并发症。
