Singh V, Singh V P, Shankar R R
Commandant, Command Hospital (Western Command), Chandimandir-134 107.
Classified Specialist (Anaesthesiology), Military Hospital, Agra.
Med J Armed Forces India. 2001 Jan;57(1):31-4. doi: 10.1016/S0377-1237(01)80086-1. Epub 2011 Jul 21.
Eighty female patients in the age group of 20-40 years, weighing 40 ± 15 Kg, in ASA physical status I and II, awaiting either elective or emergency caesarean delivery were selected for this study. Patients with cardiovascular disorders and those with significant systemic ailments were excluded from the study. They were randomly divided into two equal groups of 40 patients each. Group I was subdivided randomly into two equal sub-groups (1A and 1B) of 20 patients each and was selected for administration of epidural narcotics. Patients in sub-group 1A were given epidural morphine in the dose of 3-5 mg and those in subgroup 1B were given buprenorphine in the dose of 0.1-0.15 mg. Group II consisting of 40 patients, were again subdivided randomly into two equal subgroups (2A and 2B) of 20 patients each and were selected for administration of parenteral (intravenous) narcotics. Patients in subgroup 2A were given morphine in the dose of 5-7.5 mg I.V., and those in subgroup 2B were given 0.15-0.3 mg of buprenorphine intravenously. The degree of pain relief was assessed by applying numerical rating scale (NRS) and resulting complications were observed and recorded. It was found that 60-80% of patients with epidural narcotics, with various dosage schedules, experienced good to excellent analgesia as compared to 30-40% of patients with parenteral use of narcotics.
本研究选取了80名年龄在20至40岁之间、体重40±15千克、ASA身体状况为I级和II级、等待择期或急诊剖宫产的女性患者。患有心血管疾病和严重全身性疾病的患者被排除在研究之外。她们被随机分为两组，每组40名患者。第一组又被随机分为两个相等的亚组（1A和1B），每组20名患者，被选定接受硬膜外麻醉药给药。1A亚组的患者接受3 - 5毫克剂量的硬膜外吗啡给药，1B亚组的患者接受0.1 - 0.15毫克剂量的丁丙诺啡给药。由40名患者组成的第二组再次被随机分为两个相等的亚组（2A和2B），每组20名患者，被选定接受胃肠外（静脉内）麻醉药给药。2A亚组的患者接受5 - 7.5毫克静脉注射吗啡给药，2B亚组的患者接受0.15 - 0.3毫克丁丙诺啡静脉注射给药。通过应用数字评分量表（NRS）评估疼痛缓解程度，并观察和记录由此产生的并发症。结果发现，与30 - 40%的胃肠外使用麻醉药的患者相比，60 - 80%接受各种给药方案的硬膜外麻醉药的患者经历了良好至优秀的镇痛效果。
