Marshall H, Porteous C, McMillan I, MacPherson S G, Nimmo W S
Br Med J (Clin Res Ed). 1985 Jul 6;291(6487):19-21. doi: 10.1136/bmj.291.6487.19.
To see whether continuous intravenous infusion of opiates provides more effective postoperative relief of pain than conventional intramuscular injection these regimens were compared in a prospective double blind trial. Thirty patients undergoing elective cholecystectomy were allocated randomly to receive an infusion of morphine or an infusion of placebo (control group) for 24 hours. Both groups were allowed supplementary morphine boluses as requested. During the first 48 hours after operation the degree of pain was almost identical between the groups. Surprisingly, the group that was given the infusion of morphine received as much supplementary morphine as the control group during the first 24 hours and appreciably more during the 24 hours after the infusion had been withdrawn. Nausea and vomiting were more prevalent among the patients given the infusion of morphine. These results suggest that continuous infusion of morphine may be an inferior regimen to intermittent bolus administration in the relief of postoperative pain. This may be explained by the development of tolerance in patients who received the infusion of morphine.
为了观察静脉持续输注阿片类药物是否比传统肌肉注射能更有效地缓解术后疼痛，在一项前瞻性双盲试验中对这些给药方案进行了比较。30例行择期胆囊切除术的患者被随机分配接受吗啡输注或安慰剂输注（对照组）24小时。两组均可根据需要追加吗啡推注。术后头48小时内，两组疼痛程度几乎相同。令人惊讶的是，接受吗啡输注的组在最初24小时内接受的追加吗啡量与对照组相同，且在输注停止后的24小时内接受的追加吗啡量明显更多。接受吗啡输注的患者中恶心和呕吐更为普遍。这些结果表明，在缓解术后疼痛方面，持续输注吗啡可能不如间歇性推注给药方案。这可能是由于接受吗啡输注的患者产生了耐受性。
