Derbyshire D R, Bell A, Parry P A, Smith G
Br J Anaesth. 1985 Sep;57(9):858-65. doi: 10.1093/bja/57.9.858.
Eighty patients undergoing abdominal surgery were studied after operation. Morphine was administered regularly every 4 h by either the i.m. (morphine sulphate 10 mg) or the oral route (MST Continus 20 mg) in a double-blind double-dummy trial. Both MST and i.m. morphine provided satisfactory postoperative analgesia, but significantly greater amounts of supplementary i.m. morphine were required in the MST group. More adverse effects were reported by the patients in the i.m. morphine group. The mean serum morphine concentration in 12 patients in the MST group was 1.7 ng ml-1 at 08.00 h and 19.5 ng ml-1 at 16.00 h on the 1st day after operation, suggesting impaired gastric emptying in the early postoperative period. It is therefore recommended that further studies of the bioavailability of MST in the early postoperative period be undertaken before any recommendations are made regarding its routine use for pain relief at that time.
对80例接受腹部手术的患者术后进行了研究。在一项双盲双模拟试验中，每4小时定期通过肌肉注射（硫酸吗啡10毫克）或口服（美施康定20毫克）给予吗啡。美施康定和肌肉注射吗啡均提供了满意的术后镇痛效果，但美施康定组需要显著更多剂量的补充肌肉注射吗啡。肌肉注射吗啡组的患者报告了更多的不良反应。美施康定组12例患者术后第1天08:00时的平均血清吗啡浓度为1.7纳克/毫升，16:00时为19.5纳克/毫升，提示术后早期胃排空受损。因此，建议在就美施康定在术后早期常规用于缓解疼痛提出任何建议之前，进一步研究其在术后早期的生物利用度。
