Vuilleumier P A, Buclin T, Biollaz J
Service d'anesthésie, Hôpital Daler, Fribourg.
Schweiz Med Wochenschr. 1998 Feb 14;128(7):259-63.
To compare the analgesic efficacy and tolerance of propacetamol and morphine, 80 patients in good clinical condition were included in a prospective, parallel, randomized double blind trial after elective surgery expected to elicit light to moderate postoperative pain. At the end of general anesthesia, 40 patients received 30 mg/kg propacetamol and 40 0.2 mg/kg morphine, as a 15-min intravenous infusion. The groups were similar for age, weight and duration of anesthesia. Supplemental analgesia had to be given in 7 cases from the propacetamol group vs. 2 cases from the morphine group. The postoperative pain, evaluated 7 times during 4 h from the end of infusion with a visual analog scale, revealed a modest advantage for morphine at 0.5 and 4 h (p = 0.05). The respiratory rate was slightly lower after morphine (p = 0.02). No significant differences were observed in blood oxygen saturation, blood pressure, heart rate, body temperature and vigilance evaluated by the trailmaking test. Nausea was present in 4 cases under propacetamol and 3 under morphine, and pruritus in 2 and 7 cases, respectively. In conclusion, propacetamol may represent an alternative to morphine for pain prevention after mildly to moderately painful surgery in situations where the use of opioids is unsuitable.
为比较醋氨酚丙泊酚和吗啡的镇痛效果及耐受性，80例临床状况良好的患者纳入一项前瞻性、平行、随机双盲试验，这些患者均接受了预计会引起轻至中度术后疼痛的择期手术。在全身麻醉结束时，40例患者接受30mg/kg醋氨酚丙泊酚，40例患者接受0.2mg/kg吗啡，均静脉输注15分钟。两组患者在年龄、体重和麻醉持续时间方面相似。醋氨酚丙泊酚组有7例患者需要追加镇痛药物，而吗啡组有2例。在输注结束后的4小时内，用视觉模拟评分法评估7次术后疼痛情况，结果显示在0.5小时和4小时时吗啡组有一定优势（p = 0.05）。吗啡组术后呼吸频率略低（p = 0.02）。通过连线测验评估的血氧饱和度、血压、心率、体温和警觉性方面未观察到显著差异。醋氨酚丙泊酚组有4例患者出现恶心，吗啡组有3例；瘙痒分别为2例和7例。总之，在不适合使用阿片类药物的情况下，醋氨酚丙泊酚可作为轻至中度疼痛手术后预防疼痛的吗啡替代药物。
