Stephen G W, Cooper L V
Anaesthesia. 1977 Apr;32(4):324-7. doi: 10.1111/j.1365-2044.1977.tb11629.x.
The study of the effect of analgesics in the newborn is difficult in the clinical situation and resort must be made to animals. Pethidine given within 1 hour of delivery is believed to cause less depression than when the time interval is longer. This study investigates whether it is pethidine or its metabolites which cause respiratory depression by comparing the respiratory effects of pethidine and its metabolites in the newborn rabbit. Fentanyl and buphrenorphine were also investigated as alternative analgesics. The response in the newborn rabbit to anoxia, is periods of dyspnoea, primary apnoea, and gasping. The metabolites of pethidine increased the primary apnoea signifying depression almost as much as pethidine. Depression was also produced when anoxia was induced 5 minutes after pethidine. Fentanyl caused less depression than pethidine or its metabolites excepting normeperidinic acid. Buphrenorphine administration resulted in the least depression with little difference between the low and high doses. Thus both pethidine and its metabolites are factors in the persisting depression, while buphrenorphine compared well with pethidine and fentanyl.
在临床情况下，研究镇痛药对新生儿的影响很困难，因此必须借助动物实验。人们认为，在分娩后1小时内给予哌替啶，其造成的抑制作用比间隔时间更长时要小。本研究通过比较哌替啶及其代谢产物对新生兔呼吸的影响，来探究是哌替啶还是其代谢产物导致呼吸抑制。同时还研究了芬太尼和丁丙诺啡作为替代镇痛药的情况。新生兔对缺氧的反应是出现呼吸急促、原发性呼吸暂停和喘息期。哌替啶的代谢产物几乎与哌替啶一样，会增加原发性呼吸暂停，这表明存在抑制作用。在给予哌替啶5分钟后诱导缺氧时，也会产生抑制作用。除去甲哌替啶酸外，芬太尼造成的抑制作用比哌替啶或其代谢产物要小。给予丁丙诺啡导致的抑制作用最小，低剂量和高剂量之间几乎没有差异。因此，哌替啶及其代谢产物都是导致持续抑制的因素，而丁丙诺啡与哌替啶和芬太尼相比效果良好。
