Comparison of efficacy of different doses of intrathecal morphine and fentanyl before operation for postoperative analgesia in patients undergoing abdominal hysterectomy / 中华麻醉学杂志

ABSTRACT

Objective To compare the efficacy of different doses of intrathecal administration of morphine and fentanyl before operation for postoperative analgesia in patients undergoing abdominal hysterectomy.Methods Forty ASA Ⅰ or Ⅱ patients,aged 19-60 yr,undergoing abdominal hysterectomy under combined spinal-epidural anesthesia,were randomly divided into Ⅰ and Ⅱ groups (n =20 each).Morphine 0.5 mg+ fentanyl 15 μg and morphine 0.2 mg+ fentanyl 25 μg were injected intrathecally in groups Ⅰ and Ⅱ respectively.VAS score ≤2was considered as effective analgesia.When VAS score≥ 3,morphine 0.05 mg/kg was given intravenously as rescue analgesic.The incidence of nausea and vomiting and pruritus was recorded after operation.Results Compared with group Ⅰ,no significant change was found in the percentage of patients requiring rescue morphine after operation (P ＞ 0.05),the incidence of nausea and vomiting and pruritus was significantly decreased after operation and the time when the patients passed the flatus was significantly shortened after operation in group Ⅱ (P ＜ 0.05).Conclusion Intrathecal administration of morphine 0.2 mg and fentanyl 25.μg before operation is safer and more helpful to recovery of gastrointestinal function than intrathecal administration of morphine 0.5 mg and fentanyl 15 μg before operation if they can provide the equivalent postoperative analgesia.