Article révisé par les pairs
Résumé : Thirty patients undergoing abdominal surgery were randomly assigned postoperatively into two groups for a double-blind evaluation of the analgesic potency and cardiorespiratory effects of either 50 μg sufentanil or 5 mg morphine injected epidurally. After sufentanil injection, good postoperative analgesia was obtained, with a linear analog score (LAS) of less than 5 starting 5 min after injection and lasting for more than 6 hr. Linear analog scores obtained during coughing (LASC) and during movement (LASM) were less than 5 after 10 min and lasted for more than 4 hr. Respiratory rate decreased significantly for 2 hr after sufentanil injection. After morphine, pain relief started after 20 min and lasted for more than 12 hr. Respiratory rate decreased after 30 min. Sedation was greater after sufentanil than after morphine. PaCO2, which increased significantly 1 hr after sufentanil, did not change after morphine. Peak expiratory flow significantly improved for 2 hr after both sufentanil and morphine, whereas forced vital capacity improved for 4 hr after sufentanil and 8 hr after morphine administration. Forced expiratory volume did not change with either drug. It is concluded that 5 mg morphine injected epidurally provides longer lasting analgesia than does 50 μg sufentanil, but that in the first hours analgesia is better after sufentanil. Injection of either drug was accompanied by remarkable cardiovascular stability.