Pathak K S, Anton A H, Sutheimer C A
Anesth Analg. 1985 May;64(5):509-14.
Plasma and urinary catecholamines were measured in 20 patients during scoliosis surgery to determine whether low dose fentanyl (1.5-2.5 micrograms . kg-1 . min-1) and morphine (150-250 micrograms . kg-1 . min-1) affect the catecholamine stress response to surgery differently. In all patients epinephrine (1.6-11.4 micrograms/kg) was injected locally at the operative site for hemostasis. This was an advantage because exogenous and endogenous epinephrine undergo the same fate and the increase in epinephrine might enhance otherwise subtle effects. The data indicate that both narcotics have similar effects on catecholamine metabolism but that even low doses of fentanyl are more effective than morphine in obtunding the catecholamine response to painful stimuli. Also, postoperative differences in plasma epinephrine indicate that recovery of awareness, and thus the onset of postoperative pain, is more rapid in patients receiving fentanyl.
在20例脊柱侧弯手术患者中测量了血浆和尿儿茶酚胺，以确定低剂量芬太尼（1.5 - 2.5微克·千克⁻¹·分钟⁻¹）和吗啡（150 - 250微克·千克⁻¹·分钟⁻¹）对手术时儿茶酚胺应激反应的影响是否不同。所有患者均在手术部位局部注射肾上腺素（1.6 - 11.4微克/千克）以止血。这是一个优点，因为外源性和内源性肾上腺素具有相同的代谢过程，肾上腺素的增加可能会增强原本细微的效应。数据表明，两种麻醉药对儿茶酚胺代谢有相似的影响，但即使是低剂量的芬太尼在抑制儿茶酚胺对疼痛刺激的反应方面比吗啡更有效。此外，术后血浆肾上腺素的差异表明，接受芬太尼的患者意识恢复更快，因此术后疼痛的发作也更快。
