Neustein S M, Cohen E
Department of Anesthesia, Mount Sinai Medical Center, New York, NY 10029-6574.
J Cardiothorac Vasc Anesth. 1993 Apr;7(2):157-9. doi: 10.1016/1053-0770(93)90209-4.
The ability of intrathecal morphine (ITM) to reduce post-thoracotomy pain and meperidine requirements was investigated. Thirty adult patients scheduled for thoracic surgery were studied. Following induction with thiamylal sodium and succinylcholine, anesthesia was maintained with 100 micrograms of fentanyl, vecuronium, and enflurane. Prior to skin incision, 16 patients received intrathecal morphine, 12 micrograms/kg, injected at the L3-4 or L4-5 level. The other 14 patients were controls. Postoperatively, patients were evaluated for pain scores and the total doses of meperidine required over 24 hours. The patients in the ITM group required significantly less meperidine compared to the control group (59 +/- 68 v 167 +/- 97 mg, respectively) and had lower pain scores (1.4 +/- 1.1 v 2.4 +/- 0.9 mg, respectively). There were no serious side effects attributable to ITM. It is concluded that ITM is an effective adjunctive treatment for control of post-thoracotomy pain.
研究了鞘内注射吗啡（ITM）减轻开胸术后疼痛及减少哌替啶用量的能力。对30例计划行胸外科手术的成年患者进行了研究。在硫喷妥钠和琥珀酰胆碱诱导后，用100微克芬太尼、维库溴铵和恩氟烷维持麻醉。在皮肤切开前，16例患者于L3 - 4或L4 - 5水平鞘内注射12微克/千克的吗啡。另外14例患者为对照组。术后，对患者的疼痛评分及24小时内所需哌替啶的总剂量进行评估。与对照组相比，ITM组患者所需哌替啶显著较少（分别为59±68毫克和167±97毫克），且疼痛评分较低（分别为1.4±1.1和2.4±0.9）。未发现由ITM引起的严重副作用。结论是，ITM是控制开胸术后疼痛的一种有效辅助治疗方法。
