Milligan K R, Fogarty D J
Musgrave Park Orthopaedic Hospital, Belfast, N. Ireland.
Reg Anesth. 1993 Mar-Apr;18(2):114-7.
The postoperative pain scores and analgesic requirements were assessed in 60 patients who had undergone total hip replacement under bupivacaine spinal anesthesia.
Thirty of the patients had intrathecal diamorphine injected after the bupivacaine, and the remaining 30 received saline.
Superior postoperative pain relief was obtained in the diamorphine group, whose average postoperative morphine requirements were 12 +/- 11.4 mg compared to 31 +/- 18.7 mg (mean +/- SD) in the control group. Despite the lower doses of morphine, their pain scores over the first 24 hours postoperatively were consistently lower. No differences were seen between the groups with respect to respiratory depression, nausea, pruritus, postoperative sedation, headache, or urinary retention.
Pain control after intrathecal diamorphine supplemented by intravenous morphine from a patient controlled analgesia system is superior to intravenous morphine alone.
对60例在布比卡因腰麻下行全髋关节置换术的患者的术后疼痛评分及镇痛需求进行评估。
30例患者在布比卡因之后鞘内注射二氢吗啡酮，其余30例接受生理盐水注射。
二氢吗啡酮组术后镇痛效果更佳，其术后吗啡平均需求量为12±11.4毫克，而对照组为31±18.7毫克（均值±标准差）。尽管吗啡剂量较低，但他们术后头24小时的疼痛评分始终较低。两组在呼吸抑制、恶心、瘙痒、术后镇静、头痛或尿潴留方面未见差异。
鞘内注射二氢吗啡酮后通过患者自控镇痛系统静脉注射吗啡的疼痛控制效果优于单纯静脉注射吗啡。
