Department of Anesthesiolgy and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Korean J Anesthesiol. 2012 Oct;63(4):321-6. doi: 10.4097/kjae.2012.63.4.321. Epub 2012 Oct 12.
Subarachnoid block is a widely used technique for cesarean section. To improve the quality of analgesia and prolong the duration of analgesia, addition of intrathecal opioids to local anesthetics has been encouraged. We compared the effects of sufentanil 2.5 µg and 5 µg, which were added to intrathecal hyperbaric bupivacaine.
We enrolled 105 full term parturients were randomly divided into 3 groups: Group 1 (control), Group 2 (sufentanil 2.5 µg), and Group 3 (sufentanil 5 µg). In every group, 0.5% heavy bupivacaine was added according to the adjusted dose regimen. We determined the maximum level of sensory block and motor block, the quality of intraoperative analgesia, the duration of effective analgesia and side effects.
There were no significant differences among the 3 groups in the maximum level of the sensory block and motor block. Recovery rate of the sensory block, however, was significantly slower in Group 3 than Group 1. Quality of intraopertive analgesia, muscle relaxation, and duration of effective analgesia were enhanced by increasing the dosage of intrathecal sufentanil. Frequencies of hypotension, maximum sedation level, and pruritus were directly related to the dosage of intrathecal sufentanil, whereas nausea and vomiting occurred only in the groups using sufentanil.
The addition of sufentanil 2.5 µg for spinal anesthesia provides adequate intraoperative analgesia and good postoperative analgesia with minimal adverse effects on the mother.
蛛网膜下腔阻滞是剖宫产术常用的技术。为了提高镇痛质量并延长镇痛持续时间,已鼓励在局部麻醉剂中加入鞘内阿片类药物。我们比较了舒芬太尼 2.5μg 和 5μg 与布比卡因鞘内注入的效果。
我们纳入了 105 例足月产妇,随机分为 3 组:第 1 组(对照组)、第 2 组(舒芬太尼 2.5μg)和第 3 组(舒芬太尼 5μg)。每组均按调整后的剂量方案加入 0.5%重布比卡因。我们测定了最高感觉阻滞和运动阻滞水平、术中镇痛质量、有效镇痛持续时间和不良反应。
3 组间最高感觉阻滞和运动阻滞水平无显著差异。然而,第 3 组感觉阻滞的恢复速度明显慢于第 1 组。增加鞘内舒芬太尼剂量可提高术中镇痛质量、肌肉松弛和有效镇痛持续时间。低血压、最大镇静水平和瘙痒的发生率与鞘内舒芬太尼剂量直接相关,而恶心和呕吐仅发生在使用舒芬太尼的组中。
蛛网膜下腔麻醉中加入舒芬太尼 2.5μg 可提供足够的术中镇痛和良好的术后镇痛,对母亲的不良反应最小。