Brenet O, Boishardy N, Jacob J P, Lhoste F, Poirier N, Delhumeau A
Département d'Anesthésie-Réanimation chirurgicale, CHRU, Angers.
Cah Anesthesiol. 1995;43(3):319-23.
Surgery of the anterior cruciate ligament causes severe postoperative pain. This study aimed to compare efficacy and side effects of two postoperative analgesia methods, during 24 hours. Twenty healthy patients were assigned to two groups (n = 10): the patients of the first group were given by an epidural catheter 3 mg of morphine hydrochloride, every twelve hours. The patients of the second group received 2 mg h-1 of intravenous nalbuphine. The degree of pain was studied with a visual analogue scale. After the third postoperative hour, it was significantly higher in the second group, but the nalbuphine dose was low. The incidence of respiratory depression, nausea, pruritus was not statistically different between the groups, but 7/10 patients in the first group suffered of urinary retention (the first micturition was obtained 10.5 hours after the end of surgery in the first group and 5.3 h in the second one). Two patients needed an uretral catheter. These results might tend to show a greater efficactly of epidural morphine, with a higher incidence of urinary side effects.
前交叉韧带手术会导致严重的术后疼痛。本研究旨在比较两种术后镇痛方法在24小时内的疗效和副作用。20名健康患者被分为两组（每组n = 10）：第一组患者通过硬膜外导管每12小时给予3毫克盐酸吗啡。第二组患者接受每小时2毫克的静脉注射纳布啡。采用视觉模拟量表研究疼痛程度。术后第3小时后，第二组的疼痛程度明显更高，但纳布啡剂量较低。两组之间呼吸抑制、恶心、瘙痒的发生率无统计学差异，但第一组10名患者中有7名出现尿潴留（第一组在手术结束后10.5小时首次排尿，第二组为5.3小时）。两名患者需要留置导尿管。这些结果可能倾向于表明硬膜外吗啡的疗效更好，但泌尿副作用的发生率更高。
