Akashi K, Matsunaga M, Dan K
Department of Anesthesiology, Fukuoka University, School of Medicine.
Masui. 1993 Jul;42(7):1038-42.
This study was designed to compare the influence of epidural anesthesia with that of general anesthesia on postoperative pain state and management. We studied 16 patients who underwent elective laparotomy-cholecystectomy with epidural anesthesia without general anesthesia or with general anesthesia (nitrous oxide-isoflurane). Following bolus epidural injection with 3 micrograms.kg-1 of buprenorphine in 0.25% bupivacaine 4-7 ml at the end of surgery, all patients received continuous epidural buprenorphine administration at the rate of 12 micrograms.h-1 for 48 hours. Pain relief was assessed for 72 hours after surgery using visual analogue scale. Postoperative rest pain of the epidural group remained at a lower state of pain than that of the general anesthesia group not only for 48 hours (P < 0.005) but also until 72 hours (P < 0.005) after surgery. We concluded that the epidural anesthesia produces a greater postoperative pain relief than general anesthesia.
本研究旨在比较硬膜外麻醉与全身麻醉对术后疼痛状态及处理的影响。我们研究了16例接受择期剖腹胆囊切除术的患者,这些患者接受单纯硬膜外麻醉或全身麻醉(氧化亚氮-异氟烷)。在手术结束时,向硬膜外注入3微克/千克的丁丙诺啡加4-7毫升0.25%布比卡因,之后所有患者以12微克/小时的速率持续硬膜外给予丁丙诺啡48小时。术后使用视觉模拟量表评估72小时的疼痛缓解情况。硬膜外组术后静息痛不仅在术后48小时(P<0.005),而且直到术后72小时(P<0.005)都维持在比全身麻醉组更低的疼痛状态。我们得出结论,硬膜外麻醉比全身麻醉能产生更好的术后疼痛缓解效果。