Wilson R J, Leith S, Jackson I J, Hunter D
Department of Anaesthetics, York District Hospital.
Anaesthesia. 1994 Jul;49(7):591-3.
Forty patients undergoing total abdominal hysterectomy were randomly allocated to receive either 40 micrograms.kg-1 of alfentanil on induction of anaesthesia or 40 micrograms.kg-1 of alfentanil after the skin incision. Postoperative pain relief was provided with morphine from a patient-controlled analgesia system. The amount of morphine consumed in the operating theatre, while in recovery and for the first 24 h postoperatively was recorded. Pain scores were assessed at 24 h using a visual analogue scale. There were no differences found between the two groups for morphine consumption but the 'pre-emptive' group had significantly higher pain scores at rest. We conclude that there is no clinically useful pre-emptive analgesic effect with this dose of alfentanil and that therefore systemic opioid premedication is unlikely to decrease postoperative analgesic requirements through the mechanism of pre-emptive analgesia.
40例行全腹子宫切除术的患者被随机分配，在麻醉诱导时接受40微克/千克的阿芬太尼，或在皮肤切口后接受40微克/千克的阿芬太尼。术后通过患者自控镇痛系统用吗啡缓解疼痛。记录在手术室、恢复期间以及术后头24小时内消耗的吗啡量。术后24小时使用视觉模拟量表评估疼痛评分。两组之间在吗啡消耗量上没有差异，但“超前镇痛”组在静息时的疼痛评分明显更高。我们得出结论，该剂量的阿芬太尼没有临床上有用的超前镇痛效果，因此全身阿片类药物术前用药不太可能通过超前镇痛机制降低术后镇痛需求。
