D'Angelo R, Evans E, Dean L A, Gaver R, Eisenach J C
Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Anesth Analg. 1999 Mar;88(3):573-6. doi: 10.1097/00000539-199903000-00020.
We sought to determine whether spinal clonidine 50 microg prolongs the analgesia from the spinal administration of sufentanil 7.5 microg and bupivacaine 2.5 mg early in the first stage of labor. Thirty patients were randomized to receive a 2-mL spinal injection of sufentanil 7.5 microg + bupivacaine 2.5 mg with or without clonidine 50 microg using a combined spinal-epidural (CSE) technique. Pain, nausea, pruritus, sedation, motor block, blood pressure, and heart rate were assessed until the patient requested additional analgesia. Analgesia was significantly prolonged in patients who received spinal sufentanil + bupivacaine + clonidine (197 +/- 70 vs 132 +/- 39 min; P = 0.004). Pain scores and side effects, including motor block, sedation, and hypotension, were similar between groups. Spinal clonidine significantly prolongs labor analgesia from spinal sufentanil and bupivacaine without producing serious adverse side effects.
We studied the effects of spinal clonidine administered with spinal sufentanil and bupivacaine on labor analgesia using a combined spinal-epidural technique and conclude that spinal clonidine significantly prolongs labor analgesia from spinal sufentanil and bupivacaine without producing serious adverse effects.
我们试图确定在分娩第一产程早期，脊髓给予50微克可乐定是否能延长7.5微克舒芬太尼和2.5毫克布比卡因脊髓给药后的镇痛时间。30例患者采用联合脊髓硬膜外（CSE）技术随机接受2毫升脊髓注射，其中一组为7.5微克舒芬太尼+2.5毫克布比卡因，另一组在此基础上加用50微克可乐定。评估疼痛、恶心、瘙痒、镇静、运动阻滞、血压和心率，直至患者要求追加镇痛。接受脊髓舒芬太尼+布比卡因+可乐定的患者镇痛时间显著延长（197±70分钟对132±39分钟；P = 0.004）。两组间疼痛评分及包括运动阻滞、镇静和低血压在内的副作用相似。脊髓给予可乐定可显著延长脊髓舒芬太尼和布比卡因的分娩镇痛时间，且不产生严重不良副作用。
我们采用联合脊髓硬膜外技术研究了脊髓给予可乐定与脊髓舒芬太尼和布比卡因联合应用对分娩镇痛的影响，得出结论：脊髓给予可乐定可显著延长脊髓舒芬太尼和布比卡因的分娩镇痛时间，且不产生严重不良反应。
