Gustafsson L L, Schildt B, Jacobsen K
Br J Anaesth. 1982 May;54(5):479-86. doi: 10.1093/bja/54.5.479.
The Swedish Society of Anaesthetists conducted a nationwide retrospective survey of clinical experience with extradural and intrathecal opiates. Special interest was focused on the frequency and type of ventilatory depression. The questionnaire was answered by 84 of 93 departments (90%). Up to May 1981 extradural morphine had been given to approximately 6000-9150 patients, extradural pethidine to 220-450 and intrathecal morphine to 90-150 patients. Ventilatory depression requiring treatment with naloxone was reported in 23 patients treated with extradural morphine (0.25-0.40%) and in six given intrathecal morphine (4-7%). In 22 patients the administration of extradural morphine was considered as a major contributory factor for the occurrence of ventilatory depression. Only two of these 22 patients experienced ventilatory depression later than 6 h after the last dose of opiates (S.C., i.m., i.v. or extradural). Patients aged 70 yr or more, those receiving thoracic extradural puncture and those with reduced ventilatory capacity seemed to be overrepresented.
瑞典麻醉师协会对硬膜外和鞘内使用阿片类药物的临床经验进行了一项全国性回顾性调查。特别关注的是呼吸抑制的频率和类型。93个科室中有84个（90%）回复了问卷。截至1981年5月，约6000 - 9150例患者接受了硬膜外吗啡治疗，220 - 450例患者接受了硬膜外哌替啶治疗，90 - 150例患者接受了鞘内吗啡治疗。据报告，23例接受硬膜外吗啡治疗的患者（0.25 - 0.40%）和6例接受鞘内吗啡治疗的患者（4 - 7%）出现了需要用纳洛酮治疗的呼吸抑制。在22例患者中，硬膜外吗啡的使用被认为是呼吸抑制发生的主要促成因素。这22例患者中只有2例在最后一剂阿片类药物（皮下、肌肉注射、静脉注射或硬膜外注射）后6小时后出现呼吸抑制。70岁及以上的患者、接受胸部硬膜外穿刺的患者以及呼吸功能降低的患者似乎占比过高。
