Women experience more pain and require more morphine than men to achieve a similar degree of analgesia
Women experience more pain and require more morphine than men to achieve a similar degree of analgesia
复制标题
DOI：
10.1213/01.ane.0000080153.36643.83
复制
发表时间：
2003-11-01
影响因子：
5.7
通讯作者：
Carr, DB
中科院分区：
文献类型：
--
作者：
Cepeda, MS;Carr, DB
疼痛感知和阿片类药物反应的性别差异已经被描述，但研究结果并不一致。我们试图确定性对手术后疼痛感知、吗啡消耗和吗啡镇痛的影响。我们设计了一项前瞻性队列研究，纳入了 423 名女性和 277 名男性，她们在手术后从全身麻醉中苏醒，并且报告疼痛强度在 0-10 数字评定量表 (NRS) 上大于或等于 5。我们每 10 分钟静脉注射 2.5 毫克吗啡，直到疼痛强度小于或等于 10 分之 4。每 10 分钟，患者在 NRS 上评估其疼痛，并以 5 点李克特量表表示疼痛缓解程度。在调整手术类型和年龄后，我们发现女性比男性有更剧烈的疼痛，并且吗啡消耗量更大。 NRS 疼痛强度差异为 0.4 U（95% 置信区间，0.1-0.6 U）。女性比男性需要多 0.03 毫克/公斤吗啡（95% 置信区间，0.02-0.04 毫克/公斤）。我们得出的结论是，与男性相比，女性疼痛更剧烈，需要多 30% 的吗啡才能达到相似程度的镇痛效果。临床医生应预见阿片类药物需求的差异，以避免女性疼痛治疗不足。
Sex differences in pain perception and in response to opioids have been described, but the findings are inconsistent. We sought to determine the effect of sex on pain perception, morphine consumption, and morphine analgesia after surgery. We designed a prospective cohort study and included 423 women and 277 men who emerged from general anesthesia after surgical procedures and who reported pain intensity of greater than or equal to 5 on the 0-10 numeric rating scale (NRS). We administered 2.5 mg of morphine IV every 10 min until the pain intensity was less than or equal to 4 of 10. Every 10 min, patients rated their pain on the NRS and indicated the degree of pain relief on a 5-point Likert scale. After adjustment for type of operation and age, we found that women had more intense pain and had larger morphine consumption than men. The difference in NRS pain intensity was 0.4 U (95% confidence interval, 0.1-0.6 U). Women required 0.03 mg/kg more morphine than men (95% confidence interval, 0.02-0.04 mg/kg). We conclude that women have more intense pain and require 30% more morphine to achieve a similar degree of analgesia compared with men. Clinicians should anticipate the differences in opioid requirement to avoid undertreatment of pain in women.