Fujikawa T, Nakamura Y, Takeda H, Matsusue S, Kato Y, Nishiwada M
Department of Abdominal Surgery, Tenri Hospital, Nara, Japan.
Surg Today. 1998;28(1):18-22. doi: 10.1007/BF02483603.
This study was undertaken to determine whether short-term continuous epidural analgesia using morphine would relieve pain after laparoscopic cholecystectomy. The authors retrospectively reviewed the clinical data of 182 cases who had undergone a laparoscopic cholecystectomy. These cases were divided into four groups according to their anesthetic modes as follows: a control group with general anesthesia only (n = 37); group I, general anesthesia combined with one shot of epidural morphine (n = 78); and group II, general anesthesia combined with continuous epidural analgesia using morphine (IIa for 12 h (n = 33); IIb for 8 h (n = 34)). The pain score on a four-category verbal scale and the frequency of analgesic use were investigated. There were no differences in the background characteristics of the patients among the groups, except for the duration of surgery (I vs IIa; P = 0.006). The pain scores were significantly different between the control group and the other groups. The frequency of analgesic use in the control group was also significantly higher than in the other groups. A tendency toward a higher frequency of analgesic use in group I, compared with that in groups IIa and IIb, was observed. These findings thus suggest that short-term continuous epidural analgesia using morphine can effectively relieve postoperative pain after a laparoscopic cholecystectomy.
本研究旨在确定使用吗啡进行短期连续硬膜外镇痛是否能缓解腹腔镜胆囊切除术后的疼痛。作者回顾性分析了182例行腹腔镜胆囊切除术患者的临床资料。这些病例根据麻醉方式分为四组，具体如下：仅行全身麻醉的对照组（n = 37）；第一组，全身麻醉联合单次硬膜外注射吗啡（n = 78）；第二组，全身麻醉联合使用吗啡进行连续硬膜外镇痛（IIa组为12小时（n = 33）；IIb组为8小时（n = 34））。调查了四类言语量表的疼痛评分和镇痛药物使用频率。除手术时间外（第一组与IIa组比较；P = 0.006），各组患者的背景特征无差异。对照组与其他组之间的疼痛评分有显著差异。对照组的镇痛药物使用频率也显著高于其他组。观察到第一组的镇痛药物使用频率有高于IIa组和IIb组的趋势。因此，这些研究结果表明，使用吗啡进行短期连续硬膜外镇痛可有效缓解腹腔镜胆囊切除术后的疼痛。
