[硬膜外阿片类药物用于缓解慢性疼痛[作者简介]。

Anesthesie, analgesie, reanimation Pub Date : 1981-01-01
M Stoyanov, H Müller, G Hempelmann
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引用次数: 0

摘要

对75例因腹部肿瘤引起的慢性疼痛患者进行硬膜外麻醉。为了减少局部感染的风险,部分硬膜外导管置于皮下。测定硬膜外吗啡(加布比卡因和不加布比卡因)、哌嗪或芬太尼后的镇痛程度和持续时间。测量血液动力学和呼吸参数并记录副作用。硬膜外吗啡组镇痛持续时间最长。在长期治疗中,效率降低,每日注射频率增加,特别是那些在硬膜外阿片类药物给药之前已经接受全身阿片类药物的患者。这可能是由于脊髓受体的耐受性。硬膜外吗啡与小剂量局部麻醉剂联合使用可延长作用时间并延迟耐受性的发生。除了对呼吸功能有轻微影响外,这可能是指全身吸收的初始阶段,没有相关的副作用。考虑到某些预防措施,硬膜外应用吗啡在治疗慢性疼痛方面可能比全身镇痛药有优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Epidural opiates for relief of chronic pain (author's transl)].

Epidural opiate application was performed in 75 patients with chronic pain due to abdominal cancer. To reduce the risk of local infection, the epidural catheter was in part placed subcutaneously. Degree and duration of analgesia were determined after epidural morphine (with and without bupivacaine), pethidine or fentanyl. Hemodynamic and respiratory parameters were measured and side-effects were registered. The longest duration of analgesia was observed after epidural morphine. In long-term treatment there was a reduced efficiency and the frequency of daily injections increased, especially in those patients who already had received systemic opiates prior to the epidural opiate administration. This may be due to tolerance of the spinal receptors. A combination of epidural morphine with small doses of local anesthetics caused prolonged action and delayed the onset of tolerance. Besides slight influences on respiratory function, which may be referred to the initial period of systemic absorption, there were no relevant side-effects. Regarding certain precautions the epidural application of morphine may have advantages in comparison to systemic analgetics in treatment of chronic pain.

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