Abboud T K, Moore M, Zhu J, Murakawa K, Minehart M, Longhitano M, Terrasi J, Klepper I D, Choi Y, Kimball S
Anesth Analg. 1987 Sep;66(9):887-93.
To determine the safety, efficacy, and the ventilatory responses to carbon dioxide (CO2) of epidurally administered butorphanol or morphine, 122 healthy women who underwent cesarean section with epidural anesthesia were studied. Patients were randomly assigned to receive one of four epidural regimens for the relief of postoperative pain: 5 mg morphine (n = 32), 4 mg butorphanol (n = 30), 2 mg butorphanol (n = 29), or 1 mg butorphanol (n = 31). Epidural morphine provided satisfactory analgesia with slow onset and long duration of approximately 21 hr. When butorphanol was administered, analgesia of rapid onset was seen with increasing duration and effectiveness observed with increasing dose; approximately 8 hr when using 4 mg. Sixty-two percent of the patients who received morphine had pruritus. Somnolence was the main side effect encountered in patients who received epidural butorphanol. The ventilatory response to CO2 was depressed after morphine and after 2 and 4 mg butorphanol, but the duration of depression was more prolonged after morphine. It is concluded that epidural butorphanol is effective in providing pain relief after cesarean section with minor side effects. However, patients must be observed closely because of possible respiratory depression.
为了确定硬膜外给予布托啡诺或吗啡的安全性、有效性以及对二氧化碳（CO2）的通气反应，对122例行硬膜外麻醉剖宫产的健康女性进行了研究。患者被随机分配接受四种硬膜外镇痛方案之一以缓解术后疼痛：5毫克吗啡（n = 32）、4毫克布托啡诺（n = 30）、2毫克布托啡诺（n = 29）或1毫克布托啡诺（n = 31）。硬膜外吗啡起效缓慢，镇痛效果满意，持续时间约21小时。给予布托啡诺时，起效迅速，随着剂量增加，镇痛持续时间延长且效果增强；使用4毫克时约为8小时。接受吗啡治疗的患者中有62%出现瘙痒。嗜睡是接受硬膜外布托啡诺治疗患者的主要副作用。吗啡以及2毫克和4毫克布托啡诺给药后，对CO2的通气反应均受到抑制，但吗啡给药后抑制持续时间更长。得出的结论是，硬膜外布托啡诺在剖宫产术后镇痛有效，副作用较小。然而，由于可能出现呼吸抑制，必须密切观察患者。
