Klepper I D, Sherrill D L, Boetger C L, Bromage P R
Department of Anesthesiology, University of Colorado Health Sciences Center, Denver.
Br J Anaesth. 1987 Sep;59(9):1147-56. doi: 10.1093/bja/59.9.1147.
The effects of extradural sufentanil 50 micrograms were investigated in 10 normal volunteers. Eight of these were studied at a second session when adrenaline 1:200,000 was added to the sufentanil. Well-defined segmental analgesia developed rapidly after plain sufentanil and lasted approximately 3 h. Respiration was depressed for about the same period and was greatest in the first 2 h, as shown by a 15% increase in PECO2, while the slope and VE50 of the carbon dioxide response curve were depressed by 45% and 55%, respectively. Moderate drowsiness occurred in most subjects, while other side effects of itching, nausea and urinary retention occurred less frequently and were not severe. Addition of adrenaline 1:200,000 intensified segmental analgesia and prolonged duration to 5 h, while side effects were lessened. It is concluded that extradural sufentanil shows considerable promise for clinical use, and that the risk: benefit ratio is improved by adding adrenaline 1:200,000.
在10名正常志愿者中研究了硬膜外注射50微克舒芬太尼的效果。其中8名志愿者在第二次实验时，舒芬太尼中加入了1:200,000的肾上腺素。单纯使用舒芬太尼后，明确的节段性镇痛迅速出现，持续约3小时。呼吸抑制在大约相同时间段出现，且在前2小时最为明显，表现为呼气末二氧化碳分压升高15%，而二氧化碳反应曲线的斜率和通气量50分别降低45%和55%。大多数受试者出现中度嗜睡，而瘙痒、恶心和尿潴留等其他副作用发生频率较低且不严重。加入1:200,000的肾上腺素可增强节段性镇痛效果并将持续时间延长至5小时，同时副作用减轻。结论是硬膜外舒芬太尼在临床应用中显示出相当大的前景，加入1:200,000的肾上腺素可改善风险效益比。
