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术后疼痛缓解:开胸手术中腰段和胸段硬膜外注射吗啡

Postoperative pain relief: lumbar and thoracic epidural morphine in thoracotomy.

作者信息

Yang T C, Chan K H, Shu C C, Jong H R, Tswei T S, Lee T Y

机构信息

Department of Anesthesiology, Veterans General Hospital-Taipei, Taiwan, R.O.C.

出版信息

Zhonghua Yi Xue Za Zhi (Taipei). 1993 Oct;52(4):235-40.

PMID:8258115
Abstract

Twenty-two patients undergoing thoracotomy were enrolled in a controlled, randomized trial to compare the effects of thoracic (group T) or lumbar (group L) epidural morphine in relieving postoperative pain. Epidural morphine was given as the patient first complained of pain in the recovery room. The effect of epidural morphine on pain relief was assessed by visual analogue scale and subjective grade. All patients were investigated 0, 10, 20, 30, 40, 50, 60, 75, 90, 105 and 120 minutes after a single bolus injection of epidural morphine. In assessment of pain relief by visual analogue scale, the difference between two groups was statistically significant (p < 0.05), evaluated 20, 30 and 40 minutes following treatment. There was no significant difference between two groups with regard to the effect of morphine as assessed by subjective grading. We concluded that thoracic epidural morphine took effect faster than lumbar epidural morphine. However, the effects of both kept similar since 50 minutes after morphine injection.

摘要

22例接受开胸手术的患者被纳入一项对照随机试验,以比较胸段硬膜外注射吗啡(T组)和腰段硬膜外注射吗啡(L组)缓解术后疼痛的效果。当患者在恢复室首次主诉疼痛时给予硬膜外吗啡。通过视觉模拟评分法和主观分级来评估硬膜外吗啡的镇痛效果。在单次推注硬膜外吗啡后的0、10、20、30、40、50、60、75、90、105和120分钟对所有患者进行调查。在通过视觉模拟评分法评估镇痛效果时,治疗后20、30和40分钟两组之间的差异具有统计学意义(p<0.05)。根据主观分级评估,两组在吗啡效果方面无显著差异。我们得出结论,胸段硬膜外吗啡起效比腰段硬膜外吗啡更快。然而,自注射吗啡50分钟后两者的效果保持相似。

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