Wright P M, Allen R W, Moore J, Donnelly J P
Department of Anaesthetics, Queen's University, Belfast.
Br J Anaesth. 1992 Mar;68(3):248-51. doi: 10.1093/bja/68.3.248.
We measured gastric emptying (by paracetamol absorption) and duration of analgesia in 30 women in labour after extradural injection of 0.375% bupivacaine 10 ml either alone or combined with fentanyl 100 micrograms. Treatment was administered double blind by random allocation after the first request for analgesia. The median (range) times to maximal serum concentration of paracetamol were 60 (15-90) min and 75 (30-180) min after administration in the control and fentanyl groups, respectively (P = 0.026), and corresponding mean (95% confidence interval) maximal concentrations of paracetamol were 27.3 (18.8-35.8) micrograms ml-1 and 18.0 (15.1-20.9) micrograms ml-1 (P = 0.020). Mean duration of analgesia, from the first extradural bolus until return of pain in those given bupivacaine alone was 113 (87-139) min and 154 (131-176) min when fentanyl was added to the local anaesthetic (P = 0.016). These results confirm the prolongation of analgesia after fentanyl supplementation of lumbar extradural analgesia, but indicate that it results in delayed gastric emptying.
我们对30名分娩期女性进行了研究，在硬膜外注射10毫升0.375%布比卡因，单独使用或联合100微克芬太尼后，测量其胃排空情况（通过对乙酰氨基酚吸收情况）及镇痛持续时间。在首次要求镇痛后，通过随机分配进行双盲治疗。对照组和芬太尼组给药后对乙酰氨基酚达到最大血清浓度的中位（范围）时间分别为60（15 - 90）分钟和75（30 - 180）分钟（P = 0.026），相应的对乙酰氨基酚平均（95%置信区间）最大浓度分别为27.3（18.8 - 35.8）微克/毫升和18.0（15.1 - 20.9）微克/毫升（P = 0.020）。仅给予布比卡因者，从首次硬膜外推注到疼痛恢复的平均镇痛持续时间为113（87 - 139）分钟，在局部麻醉药中加入芬太尼时为154（131 - 176）分钟（P = 0.016）。这些结果证实了在腰段硬膜外镇痛中添加芬太尼后镇痛时间延长，但表明这会导致胃排空延迟。
