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[强直性肌营养不良患者术后吗啡持续硬膜外输注]

[Postoperative continuous epidural infusion of morphine in a patient with myotonic dystrophy].

作者信息

Takeda T, Tohmatsu T, Harada T, Murakami N, Dohi S

机构信息

Department of Anesthesiology and Critical Care Medicine, Gifu University School of Medicine.

出版信息

Masui. 1996 Nov;45(11):1384-7.

PMID:8953873
Abstract

Patients with myotonic dystrophy present potential problems during and after anesthesia, especially respiratory dysfunction. A 42-year-old female with myotonic dystrophy associated with slight impairment of respiratory functions and muscular power, underwent abdominal total hysterectomy under epidural anesthesia uneventfully. To relieve pain after the surgery, a bolus of epidural morphine 2 mg was administered through an indwelling lumbar (L1-2) epidural catheter 30 minutes prior to the end of the surgery and followed with continuous epidural infusion of morphine at a rate of 0.083 mg.h-1 using a balloon (Multiday Infuser, Baxter) for three days. She obtained adequate analgesia after the surgery without respiratory depression or other major complications. We demonstrated that the continuous epidural infusion of morphine in a patient with myotonic dystrophy is safe and adequate for postoperative pain relief.

摘要

强直性肌营养不良患者在麻醉期间及术后存在潜在问题,尤其是呼吸功能障碍。一名42岁女性,患有强直性肌营养不良,伴有轻微呼吸功能和肌肉力量受损,在硬膜外麻醉下顺利接受了腹部全子宫切除术。为缓解术后疼痛,在手术结束前30分钟,通过留置的腰段(L1 - 2)硬膜外导管给予2 mg硬膜外吗啡推注,随后使用球囊(百特多日输注器)以0.083 mg·h-1的速率持续硬膜外输注吗啡三天。术后她获得了充分的镇痛效果,且无呼吸抑制或其他主要并发症。我们证明,对于强直性肌营养不良患者,持续硬膜外输注吗啡用于术后镇痛是安全且充分的。

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