- 期刊
Effect of Combining Ultralow-dose Naloxone with Morphine in Intravenous Patient-controlled Analgesia: The Cut-off Ratio of Naloxone to Morphine for Antiemesis after Gynecologic Surgery
並列摘要
Background/Purpose: Admixing an ultralow dose of naloxone with intravenous morphine patient-controlled analgesia (PCA) has been shown to decrease postoperative nausea. However, the cut-off ratio of the naloxone-morphine admixture for antiemetic effects has not been investigated. The purpose of this study was to investigate the cut-off ratio of naloxone-morphine admixture in PCA for antiemesis after gynecologic surgery. Methods: This double-blind study enrolled 120 female patients who were scheduled for gynecologic surgery under general anesthesia. Patients were randomly allocated to one of three groups (n = 40 for each group). The concentration of naloxone and morphine respectively was 0 μg/mL and 1 mg/mL in group 1, 0.1 μg/mL and 1 mg/mL in group 2 (1:10,000), and 1μg/mL and 1 mg/mL in group 3 (1:1000). Morphine consumption, verbal rating score of wound pain at rest and with exertion, and morphine-related side effects were investigated at 1, 2, 4 and 24 hours postoperatively. Results: A total of 112 patients completed the study (37 in group 1, 36 in group 2, 39 in group 3). The incidence of nausea during the postoperative 4-24 hours was significantly lower in group 3 than in group 1 (23.1% vs. 56.8%, p＜0.05). Furthermore, the overall incidence of severe nausea was significantly lower in group 3 than in group 1 (2.6% vs. 24.3%, p＜0.05) as was the rescue antiemetic requirements (5.1% vs. 24.3%, p＜0.05). However, there were no significant differences between groups 2 and 1. The pain scores (at rest and with exertion) and 24-hour morphine consumption were not significantly different among the three groups. Conclusion: The antiemetic efficacy of ultralow-dose naloxone combined with PCA morphine is limited by a cut-off ratio of naloxone to morphine of 1:10,000.
延伸閱讀
- Hsu, C. C., Ku, Y. H., & Chen, H. M. (2022). Short-term Naltrexone Use Associated with Delayed-onset Fever and Hepatotoxicity: A Case Report. 台灣精神醫學, 36(4), 188-189. https://doi.org/10.4103/TPSY.TPSY_33_22
- 謝欣君（2009）。Analysis of incidence of post-operative nausea and vomiting and analgesic effect in relation to different post-operative analgesic regimens and patient’s factors.〔碩士論文，亞洲大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0118-1511201215455830
- Chang, K. Y., Chang, W. K., Chang, W. L., Lin, S. M., Chan, K. H., Sung, C. S., & Tsou, M. Y. (2006). Comparison of Intravenous Patient-controlled Analgesia with Buprenorphine Versus Morphine after Lumbar Spinal Fusion-A Prospective Randomized Clinical Trial. Acta Anaesthesiologica Taiwanica, 44(3), 153-159. https://www.airitilibrary.com/Article/Detail?DocID=02541319-200609-44-3-153-159-a
- Reece, A. S. (2012). Epidemiologic and Molecular Pathophysiology of Chronic Opioid Dependence and the Place of Naltrexone Extended- Release Formulations in its Clinical Management. Substance Abuse: Research and Treatment, (2012), 115-133. https://doi.org/10.4137/SART.S9031
- 曾祥建、范守仁、陳瑞源（2014）。Increasing the Depth of Sevoflurane Anesthesia Does Not Increase the Incidence of Postoperative Nausea and Vomiting in Patients Undergoing Gynecological Surgery。輔仁醫學期刊，12(1)，27-35。https://www.airitilibrary.com/Article/Detail?DocID=18102093-201403-201404250006-201404250006-27-35