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文章基本信息

  • 标题:A Comparative Study of Epidural Administration of Morphine and Fentanyl on Analgesic Effects and Complications
  • 作者:Chung, Mi Wha ; Shin, Keun Man ; Choi, Young Kyu
  • 期刊名称:Korean Journal of Anesthesiology
  • 印刷版ISSN:2005-6419
  • 出版年度:1989
  • 卷号:22
  • 期号:5
  • 页码:734-741
  • DOI:10.4097/kjae.1989.22.5.734
  • 语种:Korean
  • 出版社:The Korean Society of Anesthesiologists,
  • 摘要:

    The discovery of the 1970s, that morphine acts on the spinal cord, opened a new field of neuropharmacological inquiry and exploration of the greatest analgesic power of intraspinal narcotics. However not only hydrophilic and poorly lipid-soluble drugs such as morphine may be expected to travel slowly to pass out of the CSF into the lipid tissues of the neuraxis but also many adverse side-effects such as respiratory depression, urinary retention, pruritus,nausea and vomiting may be expected to develop in the morphine treated patients. In contrast to morphine, highly lipid-soluble narcotics such as fentanyl pass relatively freely between the dura and pia-arachnoid, rapid onset of action and fewer adverse effects may be expected to develop in the fentanyl-treated patients. To assess the clinical usefulness of epidural administration of fentanyl rather than morphine, we compared the onset and duration of analgesic action, self-satisfactory of analgesia and adverse side-effects between morphine and fentanyl treated 27 surgical patients. The results were as follows: 1) The onset time of analgesia in the epidurally fentanyl 50 ug treated group (F50 group) and 100 ug treated group (F100 group), 12±3 and 9±3 min respectively, were significantly shortened as compared with those in the morphine 5 mg treated group (morphine group), 21±2 min (p<0.05). 2) The duration of analgesic action in the F50 and F100 groups, 2.58±0.39 and 5.43±1.33 hours respectively, were significantly shortened as compared with morphine group, 14.30±2.16 (p<0.05). 3) Among 9 morphine treated patients, 8 patients feeled excellent or good analgesia. Also 9 of 10 fentanyl 50 ug treated and 7 of 8 fentanyl 100 ug treated patients feeled excellent or good analgesia. 4) Major complications in the morphine group were urinary retention 4 cases, nausea and vomiting 4 cases and pruritus 3 cases. Whereas only 1 patient in the F100 group complained of nausea and vomiting.

  • 关键词:epidural; Morphine; fentanyl
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