Harris A P, Michitsch R U
Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287.
Curr Opin Obstet Gynecol. 1992 Dec;4(6):813-7.
Epidural analgesia remains the mainstay for providing pain relief during labor. The search continues to find the ideal combination of analgesic agents and administration techniques that will provide excellent pain relief for the mother yet minimize side effects to the mother and fetus. This article reviews recent studies of epidural analgesia, including the increased use of epidural opioids, patient-controlled epidural analgesia, and the complications of epidural analgesia (including effects on gastric emptying, maternal temperature control, and hemodynamic changes to the mother and fetus). Intrathecal (spinal) analgesia, especially using opioids, is also discussed.
硬膜外镇痛仍然是分娩期间缓解疼痛的主要方法。人们一直在寻找理想的镇痛药物与给药技术组合，既能为母亲提供出色的疼痛缓解，又能将对母亲和胎儿的副作用降至最低。本文综述了硬膜外镇痛的近期研究，包括硬膜外阿片类药物使用的增加、患者自控硬膜外镇痛以及硬膜外镇痛的并发症（包括对胃排空、母体体温调节以及母亲和胎儿血流动力学变化的影响）。还讨论了鞘内（脊髓）镇痛，尤其是使用阿片类药物的情况。
