Schmitz P, Heinrich J
Frauenheilklinik des Bezirkskrankenhauses, Stralsund, DDR.
Zentralbl Gynakol. 1990;112(11):689-95.
The opioid Fentanyl was used in a dosage of 0.15 mg via a peridural catheter for birth analgesia (PDA) in a high risk collective of 40 female patients. A prolonged analgesia with good acceptance could be achieved with low dosage. The advantages of the mobilisation could be fully used because of telemetric monitoring and missing influence of the sympathetic nerve and undisturbed motoric activity. If a caesarean section was necessary we continued the peridural analgesia using 0.5 percent Marcain. Postnatal assessment of the condition of the newborn was not disturbed. Short-term irregularities in CTG--a decrease of the rate of acceleration, a silent oscillation pattern--are interpreted in the sense of a sleeping pattern, without harmful influence on the fetus. At present PDA is the most effective method in birth analgesia. It represents a valuable contribution to the care in the field of psychomotoric preparation of patients to birth. Considering the contraindications PDA with Fentanyl can be recommended in obstetrics.
在40名高危女性患者群体中，通过硬膜外导管使用剂量为0.15毫克的阿片类药物芬太尼进行分娩镇痛（PDA）。低剂量即可实现长时间镇痛且患者接受度良好。由于采用了遥测监测，交感神经未受影响且运动活动未受干扰，因此可以充分利用活动的优势。若有必要进行剖宫产，我们会继续使用0.5%的布比卡因进行硬膜外镇痛。对新生儿状况的产后评估未受干扰。CTG的短期不规则变化——加速率降低、无反应性振荡模式——被解释为睡眠模式，对胎儿无有害影响。目前，PDA是分娩镇痛中最有效的方法。它对患者分娩心理运动准备领域的护理做出了宝贵贡献。考虑到禁忌症，芬太尼用于PDA在产科中是可以推荐的。
