Brodsky J B, Merrell R C
West J Med. 1984 May;140(5):750-3.
Two groups of morbidly obese patients undergoing a gastric stapling procedure were compared. Patients in group I received 5 mg of morphine through a lumbar epidural catheter immediately after the surgical procedure while group II patients were treated conventionally with parenterally administered morphine. In group I less narcotics were needed and patients were able to walk earlier than in group II. Length of hospital stay, time to removal of the nasogastric tube and postoperative pulmonary function were not significantly different between groups. Two patients in group I and one patient in group II had generalized pruritus, and in one study patient bradypnea developed in association with the epidural administration of morphine. It is concluded that morbidly obese patients can benefit from epidurally administered morphine and that this form of therapy has a role in the management of these patients.
对两组接受胃吻合术的病态肥胖患者进行了比较。第一组患者在手术后立即通过腰椎硬膜外导管接受5毫克吗啡，而第二组患者则采用传统的胃肠外注射吗啡治疗。与第二组相比，第一组所需的麻醉剂更少，患者能够更早行走。两组之间的住院时间、鼻胃管拔除时间和术后肺功能没有显著差异。第一组有两名患者和第二组有一名患者出现全身性瘙痒，在一项研究中，有一名患者在硬膜外注射吗啡时出现呼吸过缓。得出的结论是，病态肥胖患者可从硬膜外注射吗啡中获益，这种治疗方式在这些患者的管理中具有一定作用。
