Rubenstein R B, Spira I, Wolff W I
Am J Surg. 1976 May;131(5):566-9. doi: 10.1016/0002-9610(76)90013-1.
One hundred patients on methadone maintenance admitted to our surgical service were analyzed. The average duration of prior narcotics abuse was ten years and was followed by an average of 2.2 years of methadone maintenance treatment. Sixty-three patients were admitted on an emergency basis, half of these for trauma. Sixty-two patients underwent operative procedures. There were four deaths, none directly related to methadone use. Five patients were admitted for intestinal obstruction secondary to methadone ingestion. This disease entity results from fecal impaction which is induced by methadone's spastic effect on the gastrointestinal tract. Evidence of chronic liver disease was present in half the patients. The associated medical illnesses presented no problems with anesthesia. WHILE METHADONE MAINTENANCE WAS CONTINUED IN THE ACCUSTOMED DOSAGE, POSTOPERATIVE ANALGESIA WAS ACCOMPLISHED SATISFACTORILY WITH 5O TO 100 MG DOSES OF MEPERIDINE AT 3 HOUR INTERVALS, AS REQUIRED.
我们对收治到外科的100名接受美沙酮维持治疗的患者进行了分析。此前滥用麻醉药品的平均时长为10年，随后平均接受了2.2年的美沙酮维持治疗。63名患者为急诊入院，其中一半是因创伤入院。62名患者接受了手术。有4例死亡，均与美沙酮使用无直接关联。5名患者因美沙酮摄入继发肠梗阻入院。这种疾病实体是由美沙酮对胃肠道的痉挛作用引起的粪便嵌塞导致的。一半患者存在慢性肝病证据。相关内科疾病在麻醉方面未出现问题。在按习惯剂量继续使用美沙酮维持治疗的情况下，术后镇痛通过按需每3小时给予50至100毫克度冷丁得以满意完成。
