Craft J B, Bolan J C, Coaldrake L A, Mondino M, Mazel P, Gilman R M, Shokes L K, Woolf W A
Am J Obstet Gynecol. 1982 Apr 1;142(7):835-9. doi: 10.1016/s0002-9378(16)32528-5.
Interest in the use of epidural narcotics for analgesia has been widespread since the demonstration of opiate receptors in the spinal cord in the mid nineteen-seventies. Recently, several studies have attempted to evaluate the effectiveness of epidural narcotics for the relief of pain in labor and after cesarean section. Using the chronically catheterized maternal-fetal sheep model, we injected 5 mg of preservative-free morphine into the epidural space. No statistically significant changes were observed, neither in maternal or fetal arterial pressure and acid-base status, nor in maternal central venous pressure, systemic and pulmonary vascular resistance, cardiac output, or intrauterine pressure (p greater than 0.05). There was a significant, although small, decrease in maternal heart rate (8%) and uterine blood flow (9%) at 120 minutes (p less than 0.05), and then a return to control values. The maternal levels of morphine peaked at 15 minutes (29 ng/ml) and the fetal levels of morphine peaked at 90 minutes (3 to 4 ng/ml). We conclude that the injection of 5 mg of morphine into the maternal epidural space has no adverse effect on mother or fetus in the sheep model.
自20世纪70年代中期在脊髓中发现阿片受体以来，硬膜外使用麻醉性镇痛药进行镇痛受到广泛关注。最近，一些研究试图评估硬膜外麻醉性镇痛药缓解分娩疼痛和剖宫产术后疼痛的效果。我们采用慢性导管插入的母胎绵羊模型，向硬膜外间隙注射5毫克无防腐剂吗啡。结果发现，母羊或胎儿的动脉血压、酸碱状态、母羊中心静脉压、全身和肺血管阻力、心输出量或子宫内压力均未出现统计学上的显著变化（P>0.05）。在120分钟时，母羊心率显著下降（8%），子宫血流量显著下降（9%）（P<0.05），随后恢复到对照值。母羊体内吗啡水平在15分钟时达到峰值（29纳克/毫升），胎儿体内吗啡水平在90分钟时达到峰值（3至4纳克/毫升）。我们得出结论，在绵羊模型中，向母羊硬膜外间隙注射5毫克吗啡对母羊和胎儿均无不良影响。
