Barron D W, Strong J E
Anaesthesia. 1981 Oct;36(10):937-41. doi: 10.1111/j.1365-2044.1981.tb08651.x.
Sixty-two patients were given morphine 2 mg and 69 patients were given diamorphine 0.5 mg by either the epidural or intrathecal route. All had undergone either total hip replacement or spinal disc surgery. Forty-nine out of 131 patients required no further analgesia. Diamorphine was superior to morphine and the intrathecal route more effective than the epidural. Headache, pruritus, urinary retention and nausea and vomiting were recorded, the incidence of the latter being unacceptably high, particularly when the drugs were administered by the intrathecal route: one patient required resuscitation. It is suggested that previously reported respiratory depression using these techniques is associated with the administration of other analgesics contemporaneously; that dosage should be limited to one-fifth of the estimation intramuscular dose; and that patients should be observed in a recovery ward for 24 hours.
62例患者通过硬膜外或鞘内途径给予吗啡2毫克，69例患者通过相同途径给予二氢吗啡酮0.5毫克。所有患者均接受了全髋关节置换术或椎间盘手术。131例患者中有49例不需要进一步镇痛。二氢吗啡酮比吗啡更有效，鞘内途径比硬膜外途径更有效。记录了头痛、瘙痒、尿潴留以及恶心和呕吐情况，恶心和呕吐的发生率高得令人难以接受，尤其是当药物通过鞘内途径给药时：有1例患者需要复苏。建议先前报道的使用这些技术出现的呼吸抑制与同时使用其他镇痛药有关；剂量应限制在估计的肌肉注射剂量的五分之一；并且患者应在恢复病房观察24小时。
