luan an tom tat (eng) nghiên cứu tác dụng giảm đau của các liều morphin tiêm trước mổ vào khoang dưới nhện và PCA morphin tĩnh mạch sau mổ tầng bụng trên

MINISTRY OF EDUCATION AND TRAINING MINISTRY OF DEFENSE 108 INSTITUTE OF CLINICAL MEDICAL AND PHARMACEUTICAL SCIENCES - - DO KHAC HUNG STUDY ON ANALGESIC EFFECT OF MORPHINE DOSAGES INJECTED BEFORE SUBARACHNOID SPACE OPERATION COMBINED WITH IV-PCA MORPHINE INJECTED AFTER UPPER ABDOMINAL ONE Specialism: Code: Anesthesia Reanimation 62.72.01.22 THE SUMMARY OF MEDICAL DOCTORAL THESIS HANOI - 2018 THE THESIS HAS BEEN COMPLETED AT 108 INSTITUTE OF CLINICAL MEDICAL AND PHARMACEUTICAL SCIENCES Scientific supervisor: Prof Nguyen Thu Associate Prof PhD Cong Quyet Thang Opponent 1: Opponent 2: Opponent 3: Doctoral thesis will be evaluated at thesis evaluation council at 108 Institute of Clinical Medical and Pharmaceutical Sciences On: ………………, ……… /………./ 2018 You can find the thesis at: The National Library Library of 108 Institute Pharmaceutical Sciences of Clinical Medical and INTRODUCTION Pain affects the patients during and after surgery, causing many side-effects in respiratory, circulatory, endocrine, inflammatory process, prolonged hospital stay The consequences of postoperative pain greatly affect the recovery of health and patients’ psychology More pain caused after the upper abdominal operation, therefore, effective pain-killer measures must be required Using Intrathecal morphine (ITM) injection is a direct injection of morphine into the subarachnoid space and has been proved to be good pain-relief in the first day postoperatively while Intravenous Patient-Controlled Analgesia (IV-PCA) reduces pain effectively, especially for surgeries cause little and moderate pain The combination of spinal cord morphine injection with IVPCA has been studied by several authors to provide good analgesic effects after urological, obstetric, orthopedic surgery To find the effective dose of this combination and to meet patient’s pain-killer need after upper abdominal operation, we studied the subject: “Study on analgesic effect of morphine before subarachnoid space operation combined with IV-PCA morphine injected after upper abdominal one” for below purposes: To evaluate the analgesic effect of morphine at 0.2 mg and 0.4 mg when it’s injected before subarachnoid space operation combined intravenous PCA morphine injected after upper abdominal operation To evaluate the unexpected effects of morphine at 0.2 mg and 0.4 mg when it’s injected before subarachnoid space operation combined intravenous PCA morphine injected after upper abdominal operation SUMMARY OF THESIS’S NEW MAIN SCIENTIFIC CONTRIBUTION Injection of morphine into the spinal cord before operation combined with PCA had a good analgesic effect after upper abdominal surgery, reducing a statistically significant amount of morphine (p