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两种不同剂量鞘内注射吗啡用于电视辅助胸腔镜手术后镇痛的比较。

Comparison of two different intrathecal morphine doses for postoperative analgesia after video-assisted thoracoscopic surgery.

作者信息

Okbaz Volkan, Turktan Mediha, Gulec Ersel, Hatıpoglu Zehra, Bahcecı Cansu, Karacaoglu Ismail C

机构信息

Department of Anesthesiology and Reanimation, Cukurova University Faculty of Medicine, Adana, Turkey.

Department of Econometrics and Statistics, Adnan Menderes University Faculty of Economics, Aydın, Turkey.

出版信息

J Anaesthesiol Clin Pharmacol. 2025 Apr-Jun;41(2):219-225. doi: 10.4103/joacp.joacp_258_23. Epub 2025 Mar 22.

Abstract

BACKGROUND AND AIMS

Postoperative pain is one of the most common problems after thoracic surgery. In this study, we aimed to investigate the analgesic effects of two different doses of intrathecal morphine (ITM) based on ideal body weight in patients who underwent video-assisted thoracoscopic surgery (VATS).

MATERIAL AND METHODS

Forty-six patients scheduled for elective lung resection were included in this study. Patients were allocated to receive 10 μg/kg (Group I) and 7 μg/kg (Group II) ITM according to the ideal body weight for postoperative analgesia. Intraoperative and postoperative hemodynamic variables, postoperative morphine consumption, pain scores (at rest and effort), side effects, and additional analgesic requirements were recorded.

RESULTS

Postoperative pain scores did not differ in the first 12 h between the groups, but were significantly lower in Group I compared with Group II at 18 and 24 hours ( = 0.024 and = 0.017 at rest, and = 0.025 and = 0.002 at effort, respectively). Postoperative morphine consumption was statistically significantly lower in Group I at all time periods ( < 0.05). The incidence of side effects was similar for both groups ( > 0.05).

CONCLUSIONS

The use of 10 μg/kg ITM according to the ideal body weight provides more effective analgesia without increasing the side effects compared to 7 μg/kg ITM after VATS.

摘要

背景与目的

术后疼痛是胸外科手术后最常见的问题之一。在本研究中,我们旨在调查基于理想体重给予两种不同剂量鞘内注射吗啡(ITM)对接受电视辅助胸腔镜手术(VATS)患者的镇痛效果。

材料与方法

本研究纳入了46例计划进行择期肺切除术的患者。根据理想体重将患者分为两组,分别接受10μg/kg(I组)和7μg/kg(II组)的ITM用于术后镇痛。记录术中及术后的血流动力学变量、术后吗啡用量、疼痛评分(静息和活动时)、副作用及额外镇痛需求。

结果

两组患者术后12小时内的疼痛评分无差异,但在18小时和24小时时,I组的疼痛评分显著低于II组(静息时分别为P = 0.024和P = 0.017,活动时分别为P = 0.025和P = 0.002)。I组术后各时间段的吗啡用量在统计学上均显著低于II组(P < 0.05)。两组副作用的发生率相似(P > 0.05)。

结论

与VATS术后使用7μg/kg ITM相比,根据理想体重使用10μg/kg ITM可提供更有效的镇痛效果且不增加副作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c41/12002694/35575f2dcc3e/JOACP-41-219-g001.jpg

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