Fischer R L, Lubenow T R, Liceaga A, McCarthy R J, Ivankovich A D
Department of Anesthesiology, Rush Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
Anesth Analg. 1988 Jun;67(6):559-63.
The short duration of epidural fentanyl has limited its direct comparison with epidural morphine in previous reports. The following study was performed of continuous postoperative epidural infusions at 5 ml/hr fentanyl 10 micrograms/ml (n = 59) or morphine 0.1 mg/ml (n = 48), both with bupivacaine 0.1%, in patients having cesarean sections. Postoperative evaluations included the frequency and magnitude of clinically evident respiratory depression, the adequacy of analgesia, nausea, pruritus, the ability to ambulate, and other side effects for 24 hours. Analgesia and the number of supplemental narcotic injections needed were similar in both groups. The incidence of nausea and pruritus was significantly less in the patients receiving fentanyl. No patient developed respiratory depression in either group. Patient and staff acceptance of the continuous epidural technique was excellent because there were only minor catheter-related problems associated with its use. It is concluded that continuous epidural fentanyl combined with bupivacaine offers excellent postoperative analgesia with minimal side effects.
在以往的报告中，硬膜外注射芬太尼的作用时间较短，这限制了它与硬膜外注射吗啡进行直接比较。以下研究对剖宫产患者术后以5毫升/小时的速度持续硬膜外输注10微克/毫升的芬太尼（n = 59）或0.1毫克/毫升的吗啡（n = 48）进行了观察，两种药物均与0.1%的布比卡因混合使用。术后评估包括明显临床呼吸抑制的频率和程度、镇痛效果、恶心、瘙痒、行走能力以及24小时内的其他副作用。两组的镇痛效果和所需补充麻醉剂注射次数相似。接受芬太尼治疗的患者恶心和瘙痒的发生率明显较低。两组均无患者出现呼吸抑制。患者和医护人员对持续硬膜外技术的接受度很高，因为使用该技术仅出现了一些与导管相关的小问题。得出的结论是，持续硬膜外注射芬太尼联合布比卡因可提供出色的术后镇痛效果，且副作用最小。
