Ishiyama T, Yamaguchi T, Kashimoto S, Kumazawa T
Department of Anesthesiology, Yamanashi Medical University, 1110 Shimokato, Tamaho-cho, Nakakoma, Yamanashi 409-3898, Japan.
J Anesth. 2001;15(2):69-73. doi: 10.1007/s005400170029.
Despite adequate levels of sensory blockade, patients sometimes complain of abdominal pain during cesarean section performed under spinal anesthesia. The aim of this study was to evaluate the effects of epidural fentanyl and intravenous flurbiprofen on visceral pain during cesarean section in patients having spinal anesthesia.
Thirty ASA physical status I and II patients undergoing elective cesarean section were studied. Spinal-epidural anesthesia was performed in all groups. Group A received no additional analgesics, group B received epidural fentanyl 100 mug, and group C received flurbiprofen 50 mg i.v. immediately after the delivery. Postdelivery, intraoperative visceral pain was evaluated by using the visual analog scale. Incidence and visual analog scale scores of visceral pain and incidence of intraoperative nausea and vomiting were obtained from each patient.
Visual analog scale scores of pain were significantly lower in group B than in the other groups (P < 0.05). The incidence of nausea was comparable in all groups. The incidence of intraoperative vomiting was lower in group C than in the other groups (P < 0.05).
Epidural fentanyl, but not intravenous flurbiprofen, decreases the incidence and severity of visceral pain during cesarean section.
尽管感觉阻滞水平足够,但在脊麻下行剖宫产手术时患者有时仍会主诉腹痛。本研究的目的是评估硬膜外注射芬太尼和静脉注射氟比洛芬对脊麻下行剖宫产手术患者内脏痛的影响。
研究纳入30例美国麻醉医师协会(ASA)身体状况分级为I级和II级的择期剖宫产患者。所有组均采用腰麻-硬膜外联合麻醉。A组未给予额外的镇痛药,B组在分娩后即刻给予硬膜外注射芬太尼100μg,C组在分娩后即刻静脉注射氟比洛芬50mg。分娩后,采用视觉模拟评分法评估术中内脏痛。记录每位患者的内脏痛发生率和视觉模拟评分以及术中恶心呕吐的发生率。
B组的疼痛视觉模拟评分显著低于其他组(P<0.05)。所有组的恶心发生率相当。C组术中呕吐的发生率低于其他组(P<0.05)。
硬膜外注射芬太尼而非静脉注射氟比洛芬可降低剖宫产手术期间内脏痛的发生率和严重程度。