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首页> 外文期刊>Anaesthesia and intensive care >Subarachnoid morphine, bupivacaine and fentanyl as part of combined spinal-epidural analgesia for low anterior resection. A prospective, randomised, double-blind clinical trial.
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Subarachnoid morphine, bupivacaine and fentanyl as part of combined spinal-epidural analgesia for low anterior resection. A prospective, randomised, double-blind clinical trial.

机译：蛛网膜下腔吗啡，布比卡因和芬太尼为脊柱硬膜外联合镇痛的一部分，用于低位前切除术。一项前瞻性，随机，双盲临床试验。

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This study was designed to compare the efficacy of subarachnoid morphine alone or in combination with bupivacaine and fentanyl for combined spinal-epidural analgesia in colorectal surgery. This is a prospective, randomised, double-blind clinical trial. Sixty patients undergoing low anterior resection were assigned to one of three groups: subarachnoid morphine, bupivacaine and fentanyl, subarachnoid morphine and bupivacaine or subarachnoid morphine only. Epidural catheter placement and subarachnoid injection were done via a combined spinal-epidural Epistar needle at L2-3. The epidural catheter was used for scheduled intraoperative bupivacaine and intermittent postoperative bupivacaine and morphine administration. Intraoperative epidural bupivacaine, intraoperative intravenous fentanyl use, time to first analgesia request, postoperative visual analogue scale pain scores, tramadol requirements and side-effects were recorded for 72 hours. Postoperative analgesia was comparable in all groups. Intraoperative fentanyl and bupivacaine consumption was lowest in the morphine, bupivacaine and fentanyl group. Time to first analgesia request was longer in the morphine, bupivacaine and fentanyl compared to the morphine group (P = 0.009). Tramadol use was lower in the morphine and bupivacaine group compared to morphine, bupivacaine and fentanyl (P = 0.017) on postoperative day two. There were no significant adverse effects. All patients ambulated the morning after surgery. The addition of bupivacaine and fentanyl to subarachnoid morphine did not confer any advantage on postoperative visual analogue scale scores and tramadol use, but lowered the need for additional intraoperative intravenous fentanyl and epidural bupivacaine and prolonged the time to first analgesia request.
机译：本研究旨在比较蛛网膜下腔吗啡单独使用或联合布比卡因和芬太尼联合用于大肠外科手术中硬膜外硬膜外镇痛的疗效。这是一项前瞻性，随机，双盲临床试验。 60例行低位前切除术的患者被分为三组之一：蛛网膜下腔吗啡，布比卡因和芬太尼，蛛网膜下吗啡和布比卡因或蛛网膜下腔吗啡。硬膜外导管的置入和蛛网膜下腔注射是通过在L2-3处通过脊柱-硬膜外Epistar针进行的。硬膜外导管用于定期术中布比卡因和间歇性术后布比卡因和吗啡给药。记录术中硬膜外布比卡因，术中静脉使用芬太尼，首次镇痛时间，术后视觉模拟评分疼痛评分，曲马多需求和副作用，记录72小时。术后镇痛在所有组中均具有可比性。在吗啡，布比卡因和芬太尼组中，术中芬太尼和布比卡因的消耗量最低。与吗啡组相比，吗啡，布比卡因和芬太尼首次镇痛的时间更长（P = 0.009）。在术后第二天，与吗啡，布比卡因和芬太尼相比，吗啡和布比卡因组的曲马多使用率较低（P = 0.017）。没有明显的不良影响。所有患者在手术后的早晨走动。在蛛网膜下腔吗啡中添加布比卡因和芬太尼对术后视觉模拟量表评分和曲马多的使用没有任何优势，但是降低了术中静脉内使用芬太尼和硬膜外布比卡因的额外需求，并延长了首次镇痛的时间。

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