Glenski J A, Warner M A, Dawson B, Kaufman B
Mayo Clin Proc. 1984 Aug;59(8):530-3. doi: 10.1016/s0025-6196(12)61490-6.
Epidurally administered narcotics are increasingly used to provide relief of pain in adults after major surgical procedures. This report describes the use of epidurally administered morphine for postoperative analgesia in nine pediatric patients after 15 major surgical procedures. The mean dose of morphine was 0.12 +/- 0.03 mg/kg of body weight, and the mean duration of analgesia per dose was 10.8 +/- 4.0 hours. Catheters remained in place for a mean duration of 50.3 +/- 16.0 hours. Increasing the dose of morphine to more than 0.1 mg/kg did not prolong the duration of analgesia but it did increase the frequency of side effects. No complications from placement of the catheter and no serious side effects were encountered. The postoperative requirements for narcotics were significantly less in the patients who received morphine epidurally than in those who received narcotics parenterally. Epidurally administered morphine can provide reliable postoperative analgesia in pediatric patients. The potential benefits include improved quality of pain relief at low total requirements, improved pulmonary function, and early ambulation.
硬膜外给予麻醉剂越来越多地用于为成人重大手术后缓解疼痛。本报告描述了硬膜外给予吗啡在15例重大手术后的9例儿科患者中的术后镇痛应用。吗啡的平均剂量为0.12±0.03mg/kg体重，每剂的平均镇痛持续时间为10.8±4.0小时。导管留置的平均持续时间为50.3±16.0小时。将吗啡剂量增加至超过0.1mg/kg并未延长镇痛持续时间，但确实增加了副作用的发生率。未遇到导管置入的并发症和严重副作用。接受硬膜外吗啡的患者术后麻醉剂需求量明显低于接受胃肠外麻醉剂的患者。硬膜外给予吗啡可为儿科患者提供可靠的术后镇痛。潜在益处包括在低总需求量时改善疼痛缓解质量、改善肺功能和早期下床活动。
