糖尿病患者术后吗啡镇痛的效果

The effect of morphine on postoperative analgesia in diabetic patients

目的评价糖尿病患者术后吗啡镇痛的效果。方法下腹部手术患者20例及非糖尿病患者20例,ASAⅠ或Ⅱ级,分为糖尿病组和非糖尿病组,术后所有患者均采用静脉吗啡自控镇痛,记录两组患者的吗啡累积消耗量、镇痛评分、血糖水平和吗啡相关的不良反应。结果术后4、8、24、48h糖尿病组吗啡累积消耗量显著高于非糖尿病组(P<0.05),术后4、8、24hVAS评分糖尿病组亦显著高于非糖尿病组(P<0.05),术后糖尿病组恶心发生率显著高于非糖尿病组(P<0.05)。结论糖尿病患者术后吗啡镇痛的敏感性降低,有效的术后镇痛需要增加吗啡剂量。

Objective To evaluate the effect of diabetes mellitus on morphine requirement in the postoperative period. Methods Forty ASA Ⅰ or Ⅱ patients were recruited into this prospective study and divided into diabetic group （non-insulin-dependent diabetic patients n= 20） or no.diabetic group（n=20）. Postoperative analgesia consisted of intravenous morphine-PCA. Cumulative morphine consumption, pain scores and morphine-related adverse effects were recorded. Results The cumulative morphine consumption in diabetic patients were more than those in non-diabetic group at 4, 8,and 24 h after operation （P〈0.05）. Postoperative pain VSA scores were higher in the diabetic group at 4, 8,and 24 h after operation （P〈0.05）. More patients in the diabetic group felt nauseous （P〈0. 05）. Conclusion Responsiveness to morphine have been attenuated in diabetic patients, larger doses of morphine may be administered to diabetic patients for effective postoperative analgesia .