Sjøgren P, Laub M S, Grønnebech H, Sørensen C, Thomsen A B, Valentin N
Anaestesiafdelingen, Københavns Amts Sygehus i Gentofte.
Ugeskr Laeger. 1993 Jun 7;155(23):1791-3.
Three different post-operative pain relief schedules were investigated in a double blind study after total hip replacement. Group BS received a priming dose of buprenorphine i.m. at the time of wound closure and continued with sublingual buprenorphine every eight hours. Supplementary doses of buprenorphine i.m. could be demanded. Group B and M received a priming dose of buprenorphine and morphine respectively, and continued with sublingual placebo eight hourly. Supplementary doses of buprenorphine could be demanded by patients in Group B and supplementary doses of morphine by patients in Group M. On one occasion VAS scorings of groups BS and B were statistically significantly lower than group M, and on another occasion VAS scorings of group BS were statistically significantly lower than the other two groups. Furthermore, the number of on demand supplementary doses was statistically significantly higher in group M. It is concluded that buprenorphine administered at regular intervals as well as on demand provided better postoperative analgesia than morphine at present dose levels. In this context, only moderate advantages were obtained by administering buprenorphine at regular intervals.
在一项全髋关节置换术后的双盲研究中,对三种不同的术后疼痛缓解方案进行了调查。BS组在伤口缝合时接受一次肌肉注射丁丙诺啡的首剂,然后每八小时继续舌下含服丁丙诺啡。可要求追加肌肉注射丁丙诺啡的剂量。B组和M组分别接受一次丁丙诺啡和吗啡的首剂,然后每八小时继续舌下含服安慰剂。B组患者可要求追加丁丙诺啡的剂量,M组患者可要求追加吗啡的剂量。有一次,BS组和B组的视觉模拟评分(VAS)在统计学上显著低于M组,还有一次,BS组的VAS评分在统计学上显著低于其他两组。此外,M组按需追加剂量的次数在统计学上显著更多。得出的结论是,在目前的剂量水平下,定期给药以及按需给药的丁丙诺啡比吗啡提供了更好的术后镇痛效果。在这种情况下,定期服用丁丙诺啡仅获得了适度的优势。