Vella L M, Willatts D G, Knott C, Lintin D J, Justins D M, Reynolds F
Anaesthesia. 1985 Aug;40(8):741-7. doi: 10.1111/j.1365-2044.1985.tb10997.x.
In a randomized double-blind trial in the first stage of labour, 20 patients given fentanyl 80 micrograms in the epidural test dose of bupivacaine, were compared with 20 patients receiving an intravenous infusion designed to produce comparable plasma fentanyl concentrations, at the same time as their epidural test dose. Despite slightly higher plasma fentanyl concentrations in the intravenous fentanyl group, epidural fentanyl produced analgesia which was more complete, more rapid in onset and slightly longer lasting. Supplementary doses of bupivacaine were needed to produce analgesia in 75% of the intravenous and 30% of the epidural fentanyl group. It is clear that epidural fentanyl produces satisfactory pain relief when added to the epidural test dose, but that the presence of fentanyl in the systemic circulation makes a negligible contribution to analgesia.
在一项关于第一产程的随机双盲试验中，将20例在布比卡因硬膜外试验剂量中给予80微克芬太尼的患者，与20例在给予硬膜外试验剂量的同时接受旨在产生可比血浆芬太尼浓度的静脉输注的患者进行比较。尽管静脉注射芬太尼组的血浆芬太尼浓度略高，但硬膜外注射芬太尼产生的镇痛效果更完全、起效更快且持续时间略长。75%的静脉注射芬太尼组和30%的硬膜外注射芬太尼组需要补充布比卡因剂量才能产生镇痛效果。很明显，硬膜外注射芬太尼添加到硬膜外试验剂量中时能产生令人满意的疼痛缓解，但全身循环中芬太尼的存在对镇痛的贡献可忽略不计。
