Fogarty D J, Milligan K R
J R Soc Med. 1995 Feb;88(2):70-2.
Sixty patients undergoing elective total hip replacement under spinal anaesthesia were randomly assigned to receive either intrathecal (IT) diamorphine 0.75 mg (n = 30) or IT morphine 1.0 mg (n = 30). Postoperative pain scores, analgesic requirements and side effects were assessed by a blinded observer. Postoperative pain scores were broadly similar and satisfactory for both groups but the amount of additional IV morphine required to achieve this was significantly reduced in the morphine compared with the diamorphine group (P < 0.05). Twelve of the morphine group required no postoperative analgesics compared with four in the diamorphine group (P < 0.02). There were no differences between the groups in the incidence of side effects such as emesis and pruritus. No significant postoperative respiratory depression was noted. In the doses used intrathecal morphine provided superior postoperative analgesia to that of intrathecal diamorphine.
60例接受脊髓麻醉下择期全髋关节置换术的患者被随机分为两组，分别接受鞘内注射（IT）0.75mg海洛因（n = 30）或IT 1.0mg吗啡（n = 30）。由一名盲法观察者评估术后疼痛评分、镇痛需求和副作用。两组术后疼痛评分大致相似且均令人满意，但与海洛因组相比，吗啡组为达到此效果所需额外静脉注射吗啡的量显著减少（P < 0.05）。吗啡组有12例患者术后无需镇痛，而海洛因组为4例（P < 0.02）。两组在呕吐和瘙痒等副作用发生率方面无差异。未观察到明显的术后呼吸抑制。在所使用的剂量下，鞘内注射吗啡比鞘内注射海洛因提供了更好的术后镇痛效果。
