Purdy G, Currie J, Owen H
Br J Anaesth. 1987 Mar;59(3):319-24. doi: 10.1093/bja/59.3.319.
In a prospective comparative study 240 patients received extradural bupivacaine, either by regular timed injections or "on demand", for pain relief during the first stage of labour. Three concentrations of bupivacaine were used (0.5%, 0.375% and 0.25%). Quality and continuity of analgesia, motor blockade, spread of sensory blockade, cardiovascular changes, fetal outcome and maternal sequelae were recorded. Overall, the analgesia provided by regular top-up injections was superior to the on demand technique, especially when 0.375% bupivacaine was used. This improved analgesia was achieved without causing an increased incidence of operative deliveries or deleterious sequelae, with respect to the mother or the neonate.
在一项前瞻性对照研究中，240例患者在第一产程接受硬膜外布比卡因注射，注射方式分为定时常规注射或按需注射，以缓解疼痛。使用了三种浓度的布比卡因（0.5%、0.375%和0.25%）。记录镇痛质量与持续性、运动阻滞、感觉阻滞范围、心血管变化、胎儿结局及母体后遗症。总体而言，定时追加注射的镇痛效果优于按需注射技术，尤其是使用0.375%布比卡因时。在不增加手术分娩发生率或对母体或新生儿产生有害后遗症的情况下，实现了这种更好的镇痛效果。
