A randomized, double-blinded comparison of intrathecal morphine, sufentanil and their combination versus IV morphine patient-controlled analgesia for postthoracotomy pain
| Autor: | Marc Fischler, Nicolas Dalibon, Jean-Claude Levron, Ngai Liu, Guy Kuhlman, M. Moutafis |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
Visual analogue scale Sufentanil medicine.medical_treatment Conscious Sedation Anesthesia General Route of administration Double-Blind Method medicine Humans Prospective Studies Injections Spinal Pain Measurement Chemotherapy Pain Postoperative Morphine Patient-controlled analgesia Urinary retention business.industry Analgesia Patient-Controlled Middle Aged Urinary Retention Analgesics Opioid Fentanyl Anesthesiology and Pain Medicine Thoracotomy Anesthesia Injections Intravenous Drug Therapy Combination Female medicine.symptom Self-administration business medicine.drug |
| Zdroj: | Anesthesia and analgesia. 92(1) |
| ISSN: | 0003-2999 |
| Popis: | UNLABELLED We compared the analgesic effect of lumbar intrathecal (IT) 0.5 mg morphine (Group M, n = 10), 50 microg sufentanil (Group S, n = 10), and their combination (Group S-M, n = 10) given before general anesthesia and patient-controlled analgesia with IV morphine (Group C, n = 19) in a randomized, double-blinded study performed in patients undergoing thoracotomy. Pain visual analog scale (VAS) and morphine consumption were assessed for 24 h. In Group S-M the number of patients initially titrated with IV morphine was less than in group C (30 vs 84%, P < 0.05). Morphine requirement was higher in Group C (71 +/- 30 mg) than in Groups S (46 +/- 34 mg, P < 0.05), M (38 +/- 31 mg, P < 0.05) and S-M (23 +/- 16 mg, P < 0.01). VAS scores were significantly decreased during the first 0-11 postoperative h at rest and during the first 0-8 postoperative h on coughing in Groups M and S-M rather than in Group C. The incidence of side effects was infrequent except for urinary retention. Preoperative IT morphine or combined sufentanil and morphine could be given as a booster to achieve rapidly effective analgesia in the immediate postoperative period. IMPLICATIONS As compared with IV patient-controlled analgesia, intrathecal morphine or combined sufentanil and morphine provided superior postoperative pain relief both at rest (11 h) and on coughing (8 h) than did IV patient-controlled analgesia morphine alone. IV morphine requirement was decreased during the first postoperative day after posterolateral thoracotomy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|