Bakhshaei Mohammad Hosein, Manuchehrian Nahid, Khoshraftar Ebrahim, Mohamadipour-Anvary Hassan, Sanatkarfar Mehdy
Department of Anesthesiology, Beasat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.
Acta Med Iran. 2010 Nov-Dec;48(6):380-4.
The quality of subarachnoid block can be improved by adding opioids to the local anesthetics. We compared the analgesic effects of different doses of intrathecal sufentanil added to lidocaine %5 for elective cesarean section. This study was a prospective, randomized, double-blind, controlled trial. 90 pregnant women with ASA class I-II, scheduled for elective cesarean section under spinal anesthesia were enrolled in this study. Three groups were made of them by random; Group 1 (control group) was given lidocaine 5% (75 mg) and 2 ml of normal saline. Patients in Group 2 received lidocaine 5% (75 mg) and 5 micrograms sufentanil plus 1ml normal saline. Group 3 patients received lidocaine 5% (75 mg) and 10 micrograms sufentanil. Duration of sensory block and effective analgesia (need to analgesic) were measured. Opioid related side effects were recorded. Duration of sensory block and effective analgesia were prolonged in sufentanil groups in comparison of control group(50.3±4) that was significantly more in group 3 (128 ± 4) versus group 2 (58.3 ± 10)(P < 0.001) . There was mild to moderate respiratory depression in sufentanil groups which was more noted in group 3 (p < 0.001). No differences were detected in other side effects such as hypotension, nausea & vomiting. The addition of sufentanil 10 versus 5 micrograms to lidocaine 5% provided more duration of analgesia for cesarean delivery. So, the adding of 10 micrograms sufentanil to lidocaine 5% for cesarean section has more effective analgesia with minimum side effects.
通过在局部麻醉药中添加阿片类药物可提高蛛网膜下腔阻滞的质量。我们比较了在5%利多卡因中添加不同剂量鞘内舒芬太尼用于择期剖宫产的镇痛效果。本研究为前瞻性、随机、双盲、对照试验。90例ASA I-II级择期剖宫产孕妇纳入本研究。随机将她们分为三组；第1组（对照组）给予5%利多卡因（75mg）和2ml生理盐水。第2组患者接受5%利多卡因（75mg）和5微克舒芬太尼加1ml生理盐水。第3组患者接受5%利多卡因（75mg）和10微克舒芬太尼。测量感觉阻滞持续时间和有效镇痛时间（需要镇痛的情况）。记录阿片类药物相关的副作用。与对照组（50.3±4）相比，舒芬太尼组的感觉阻滞持续时间和有效镇痛时间延长，第3组（128±4）明显长于第2组（58.3±10）（P<0.001）。舒芬太尼组有轻度至中度呼吸抑制，第3组更明显（P<0.001）。在低血压、恶心和呕吐等其他副作用方面未发现差异。在5%利多卡因中添加10微克与5微克舒芬太尼相比，剖宫产分娩的镇痛持续时间更长。因此，在剖宫产中向5%利多卡因中添加10微克舒芬太尼具有更有效的镇痛效果且副作用最小。
