Tóm tắt

Objective: To evaluate the effects of preoperative intrathecal morphine dose of 0.3 mg on postoperative pain, extubation time and pulmonary function in patients undergoing valve repair or replacement. Materials and Method: Sixty patients were allocated into two groups, receiving either 0.3 mg of morphine intrathecally prior to anaesthesia and intravenous patient-controlled analgesia with morphine postoperatively, or only postoperative intravenous patient-controlled analgesia. Visual analog scale at rest and on profound inspiration, morphine consumption during the first 48 postoperative hours, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) preoperatively and the first and second postoperative day were measured. Extubation time, adverse effects (pruritus, postoperative nausea and vomiting, respiratory depression) were recorded. Patient characteristics, preoperative risk score, intraoperative and anesthetic data did not differ significantly between groups. Results: The total dose of sufentanil used was 88.3 ± 15.9 µg in the control group and 87.1 ± 15.5 µg in the morphine group (p > 0.05). Pain scores at rest during the first postoperative 16 hours and pain score on profound inspiration after extubation in the intrathecal group were significantly lower than those in the control group (p < 0.05). Intravenous morphine consumption in the intrathecal group was lower until the 30th hour and reduced cumulative intravenous morphine consumption by more than 45% in comparison to the control group (12.8 ± 7.5 vs. 24.2 ± 10.1 mg). There was no significant difference in FVC, FEV1, mechanical and extubation time and the incidence of pruritus, nausea and vomiting between two groups. Conclusion: Preoperative intrathecal administration of 0.3 mg morphine in patients undergoing valve surgery improved analgesia and reduced morphine consumption in the first 30 h, without delaying extubation time or improving the FEV1 and FVC. Key words: Intrathecal morphine, cardiac surgery, postoperative pain

Từ khoá

Toàn văn

PDF

Trong số này