Mansfield M, Meikle R, Miller C
Department of Anaesthesia, Stobhill General Hospital, Glasgow.
Anaesthesia. 1994 Dec;49(12):1091-3. doi: 10.1111/j.1365-2044.1994.tb04363.x.
The influence of timing of administration of peroperative alfentanil on pain and analgesic requirements after surgery was studied in 60 patients undergoing total abdominal hysterectomy with or without bilateral salpingo-oophorectomy. Thirty patients received alfentanil 7.5 micrograms.kg-1 on induction of anaesthesia, followed by alfentanil 7.5 micrograms.kg-1 90 s before surgical incision (group A). Thirty control patients received alfentanil 15 micrograms.kg-1, 10 min after abdominal incision (group B). In addition, 10 min after surgical incision both groups received morphine 0.2 mg.kg-1, given over a 10 min period. The visual analogue scores (median, interquartile range) for pain 24 h after operation were 28.5 mm (11.25-47.0) in group A and 21.0 mm (10.5-47.5) in group B, p = 0.76. There were no differences in visual analogue scores at intermediate times. Morphine consumption in the first 24 h after surgery (median, interquartile range) was 53.5 mg (37.25-60.0) in group A and 52.0 mg (39.75-71.0) in group B, p = 0.52. We conclude that postoperative morphine consumption and pain scores are no different when alfentanil 15 micrograms.kg-1 is given before or after skin incision for abdominal hysterectomy.
在60例行全腹子宫切除术（伴或不伴双侧输卵管卵巢切除术）的患者中，研究了术中给予阿芬太尼的时间对术后疼痛及镇痛需求的影响。30例患者在麻醉诱导时给予阿芬太尼7.5微克/千克，随后在手术切口前90秒给予阿芬太尼7.5微克/千克（A组）。30例对照患者在腹部切口10分钟后给予阿芬太尼15微克/千克（B组）。此外，在手术切口10分钟后，两组均在10分钟内给予吗啡0.2毫克/千克。术后24小时疼痛的视觉模拟评分（中位数，四分位间距）在A组为28.5毫米（11.25 - 47.0），在B组为21.0毫米（10.5 - 47.5），p = 0.76。在中间时间段视觉模拟评分无差异。术后24小时内吗啡消耗量（中位数，四分位间距）在A组为53.5毫克（37.25 - 60.0），在B组为52.0毫克（39.75 - 71.0），p = 0.52。我们得出结论，对于腹式子宫切除术，在皮肤切口前或后给予15微克/千克阿芬太尼时，术后吗啡消耗量和疼痛评分无差异。
