Rosen M A, Hughes S C, Shnider S M, Abboud T K, Norton M, Dailey P A, Curtis J D
Anesth Analg. 1983 Jul;62(7):666-72.
To determine the safety, efficacy, and dose response of epidurally administered morphine for analgesia after cesarean delivery, 40 healthy women who underwent cesarean delivery with epidural anesthesia were randomly assigned to receive one of four regimens for relief of postoperative pain: intramuscular administration of morphine, 7.5 mg (N = 10); or epidural administration of morphine, 2 mg (N = 10), 5 mg (N = 10), or 7.5 mg (N = 10). Evaluations were made of intensity and relief of pain, time to administration of additional analgesic medications, changes in vital signs and blood-gas tensions, and adverse effects. Intramuscular administration of 7.5 mg of morphine effectively relieved pain for only a short time. When morphine was administered epidurally, 2 mg proved ineffective whereas both 5 mg and 7.5 mg provided substantial pain relief for approximately 24 h. There were no significant changes in vital signs or blood-gas tensions. Side effects included pruritus and nausea, which occurred frequently but were usually mild and easily treated. We concluded that either 5 mg or 7.5 mg of morphine epidurally administered was effective and safe in providing prolonged analgesia after cesarean delivery.
为确定剖宫产术后硬膜外注射吗啡用于镇痛的安全性、有效性及剂量反应，40例接受硬膜外麻醉剖宫产的健康女性被随机分为四组，接受以下四种术后疼痛缓解方案之一：肌肉注射吗啡7.5毫克（N = 10）；或硬膜外注射吗啡2毫克（N = 10）、5毫克（N = 10）或7.5毫克（N = 10）。对疼痛强度和缓解情况、追加镇痛药的时间、生命体征和血气张力的变化以及不良反应进行了评估。肌肉注射7.5毫克吗啡仅在短时间内有效缓解疼痛。硬膜外注射吗啡时，2毫克无效，而5毫克和7.5毫克均能提供约24小时的显著疼痛缓解。生命体征和血气张力无显著变化。副作用包括瘙痒和恶心，发生率较高，但通常较轻且易于治疗。我们得出结论，硬膜外注射5毫克或7.5毫克吗啡在剖宫产术后提供长时间镇痛是有效且安全的。
