Pitkänen M T, Rosenberg P H, Pere P J, Tuominen M K, Seppälä T A
Department of Anaesthesia, Helsinki, Finland.
Anaesthesia. 1992 May;47(5):395-8. doi: 10.1111/j.1365-2044.1992.tb02219.x.
The effect of the addition of 0.1 mg or 0.2 mg fentanyl to 40 ml 0.5% prilocaine in intravenous regional anaesthesia of the arm was investigated in 37 patients in a randomised, double-blind study. The characteristics of the sensory and motor block were studied. There was no difference in the speed of onset of analgesia in the groups (mean latency approximately 4 min in each group). However, significantly more patients in the fentanyl 0.2 mg group (7/12) had complete anaesthesia at 15 min than in the fentanyl 0.1 mg group (1/13) and the control group (2/12) (p less than 0.05). There were no differences in the incidence of tourniquet pain immediately before cuff deflation (tourniquet time 45-87 min). After cuff deflation, in those patients who complained of wound pain within 30 min, on average the pain appeared later in the fentanyl 0.2 mg group (six patients, mean 14.3 min) than in the control group (eight patients, mean 9.4 min) (ns). In the fentanyl groups, the incidence of central nervous system side effects was greater than in the control group (fentanyl 0.1 mg 7/13 patients, fentanyl 0.2 mg 6/12 patients, control 1/12 patients) (p less than 0.05). The plasma concentrations of prilocaine after cuff deflation were higher, in a dose-dependent fashion, in the fentanyl groups than in the control group, but the concentrations of prilocaine and fentanyl did not correlate with the symptoms. Postoperative nausea occurred only in the patients who had received fentanyl.
在一项随机双盲研究中，对37例患者进行了手臂静脉区域麻醉时，在40毫升0.5%丙胺卡因中添加0.1毫克或0.2毫克芬太尼的效果研究。对感觉和运动阻滞的特征进行了研究。两组镇痛起效速度无差异（每组平均潜伏期约4分钟）。然而，芬太尼0.2毫克组（7/12）在15分钟时完全麻醉的患者明显多于芬太尼0.1毫克组（1/13）和对照组（2/12）（p<0.05）。在放气前止血带疼痛的发生率无差异（止血带时间45 - 87分钟）。放气后，在30分钟内主诉伤口疼痛的患者中，芬太尼0.2毫克组（6例患者，平均14.3分钟）疼痛出现时间平均晚于对照组（8例患者，平均9.4分钟）（无统计学差异）。在芬太尼组中，中枢神经系统副作用的发生率高于对照组（芬太尼0.1毫克组13例患者中有7例，芬太尼0.2毫克组12例患者中有6例，对照组12例患者中有1例）（p<0.05）。放气后，芬太尼组丙胺卡因的血浆浓度呈剂量依赖性高于对照组，但丙胺卡因和芬太尼的浓度与症状无关。术后恶心仅发生在接受芬太尼的患者中。
