Bostrom M A, Pakiz A M, Melnyk D L, Benke G, Cohen S
AANA J. 1994 Jun;62(3):267-72.
Meperidine (Demerol) has local anesthetic properties separate from its opioid receptor agonist effect. Unlike morphine, meperidine is structurally similar to local anesthetics. Therefore, it is not surprising that it possesses some characteristics of local anesthetics. If meperidine acts like a local anesthetic, binding to the same receptor sites and inhibiting nerve conduction, then drugs that alter the action and duration of local anesthetics may have a similar effect on it. This double-blinded investigation used low-dose meperidine as the sole intrathecal agent to determine the effect of epinephrine on the duration of sensory blockade. Thirty male ASA physical status I through III patients between the ages of 58-81 years who were scheduled for transurethral resection of the prostate or of bladder tumors were randomly assigned to receive meperidine with or without epinephrine. A continuous spinal technique was utilized, and meperidine 0.5 mg/kg was administered after ascertaining the proper position of the catheter. Fourteen of the patients received epinephrine, and 16 patients did not. There were no statistically significant differences between the two groups in terms of age, height, weight, and ASA physical status. No statistically significant prolongation of the sensory blockade was observed with the addition of epinephrine. There were no statistically significant differences between the two groups with regard to onset time or the incidence of complications. The occurrence of a full motor block in the group that did not receive epinephrine was statistically significant.
哌替啶（度冷丁）具有独立于其阿片受体激动剂作用的局部麻醉特性。与吗啡不同，哌替啶在结构上与局部麻醉药相似。因此，它具有一些局部麻醉药的特性也就不足为奇了。如果哌替啶的作用类似于局部麻醉药，能与相同的受体位点结合并抑制神经传导，那么改变局部麻醉药作用和持续时间的药物可能对其产生类似影响。这项双盲研究使用低剂量哌替啶作为唯一的鞘内用药，以确定肾上腺素对感觉阻滞持续时间的影响。30例年龄在58 - 81岁之间、拟行经尿道前列腺切除术或膀胱肿瘤切除术的美国麻醉医师协会（ASA）身体状况I至III级的男性患者，被随机分配接受含或不含肾上腺素的哌替啶。采用连续脊髓麻醉技术，在确定导管位置合适后给予0.5 mg/kg哌替啶。14例患者接受了肾上腺素，16例患者未接受。两组在年龄、身高、体重和ASA身体状况方面无统计学显著差异。添加肾上腺素后未观察到感觉阻滞有统计学显著延长。两组在起效时间或并发症发生率方面无统计学显著差异。未接受肾上腺素组出现完全运动阻滞的情况具有统计学显著性。
