Jacquinot P, Jorrot J C, Dailland P, Lirzin J D, Conseiller C
Département d'Anesthésie-Réanimation Chirurgicale, Groupe Hospitalier Cochin-Maternités, Paris.
Ann Fr Anesth Reanim. 1990;9(1):16-9. doi: 10.1016/s0750-7658(05)80031-0.
A randomized double blind study was carried out to determine whether alkalization of a 0.25% bupivacaine solution in a fentanyl-bupivacaine mixture hastened the onset, and increased the duration and quality, of extradural analgesia during labour. The study included 120 women with uncomplicated full-term gestation. Prior to the extradural injection, 0.1 ml of either 8.4% sodium bicarbonate or normal saline was randomly added to 20 ml of 0.25% bupivacaine. The patients were given 75 micrograms fentanyl with 12 ml of either alkalized or unaltered bupivacaine. Data for analysis were obtained in 106 parturients (bicarbonate group n = 54; control group n = 52). The pH of alkalized and unaltered bupivacaine were 7.07 +/- 0.01 and 5.56 +/- 0.01 respectively. There were no statistically significant differences between the bicarbonate and control groups with regard to the speed of onset of analgesia (7.08 +/- 0.7 min vs. 6.78 +/- 0.6 min), its duration (123.6 +/- 10.7 min vs. 113 +/- 6.6 min), and the number of cases of inadequate pain relief (6 and 3 respectively). The rate of maternal adverse effects, and neonatal status, were similar in both groups. It can be concluded that alkalizing a 0.25% bupivacaine solution in a fentanyl-bupivacaine mixture for epidural analgesia in labour has no clinical value.
进行了一项随机双盲研究，以确定在芬太尼-布比卡因混合物中碱化0.25%布比卡因溶液是否能加快分娩期间硬膜外镇痛的起效速度、延长其持续时间并提高其质量。该研究纳入了120例足月妊娠且无并发症的女性。在硬膜外注射前，将0.1 ml的8.4%碳酸氢钠或生理盐水随机加入20 ml的0.25%布比卡因中。给患者注射75微克芬太尼与12 ml碱化或未改变的布比卡因。对106例产妇（碳酸氢盐组n = 54；对照组n = 52）进行了数据分析。碱化和未改变的布比卡因的pH值分别为7.07±0.01和5.56±0.01。在镇痛起效速度（7.08±0.7分钟对6.78±0.6分钟）、持续时间（123.6±10.7分钟对113±6.6分钟）以及疼痛缓解不足的病例数（分别为6例和3例）方面，碳酸氢盐组和对照组之间无统计学显著差异。两组产妇的不良反应发生率和新生儿状况相似。可以得出结论，在芬太尼-布比卡因混合物中碱化0.25%布比卡因溶液用于分娩时的硬膜外镇痛没有临床价值。
