Helbo-Hansen S, Bang U, Garcia R S, Olesen A S, Kjeldsen L
Department of Anaesthesiology, Odense University Hospital, Denmark.
Acta Anaesthesiol Scand. 1988 Aug;32(6):473-6. doi: 10.1111/j.1399-6576.1988.tb02769.x.
In order to compare subarachnoid (spinal) and epidural block for caesarean section, 40 women were randomly allocated to spinal or epidural analgesia with bupivacaine. The median dose of bupivacaine was 13 mg in the spinal group versus 155 mg in the epidural group. The mean time from induction to delivery was 32 min shorter in the spinal group (P less than 0.001). In the spinal group one woman was excluded because of spontaneous labour. Three patients in the spinal and one in the epidural group failed to develop adequate analgesia to initiate surgery. For the remaining patients both techniques provided good analgesia during operation. Postoperatively, epidural block provided better pain relief. The patients in the epidural group had a lower pain score during the first 4 h after the operation (P less than 0.01). In spite of similar haemodynamic changes in the two groups, the mean base deficit in umbilical cord blood at delivery was higher in the spinal group (P less than 0.05).
为比较剖宫产蛛网膜下腔（脊髓）阻滞和硬膜外阻滞，40名女性被随机分配接受布比卡因蛛网膜下腔或硬膜外镇痛。蛛网膜下腔组布比卡因的中位剂量为13mg，而硬膜外组为155mg。蛛网膜下腔组从诱导到分娩的平均时间短32分钟（P<0.001）。蛛网膜下腔组有1名女性因自然分娩被排除。蛛网膜下腔组3例患者和硬膜外组1例患者未能产生足够的镇痛效果以启动手术。对于其余患者，两种技术在手术期间均提供了良好的镇痛效果。术后，硬膜外阻滞提供了更好的疼痛缓解。硬膜外组患者在术后最初4小时内的疼痛评分较低（P<0.01）。尽管两组有相似的血流动力学变化，但蛛网膜下腔组分娩时脐血平均碱缺失较高（P<0.05）。
