Cade L, Ashley J
Professorial Unit, Royal Women's Hospital, Carlton, Victoria.
Anaesth Intensive Care. 1993 Aug;21(4):416-9. doi: 10.1177/0310057X9302100408.
The provision of optimal analgesia after caesarean section remains a challenge as satisfactory pain relief must be combined with patient satisfaction, including the ability to care for the newborn. In a prospective study of 132 patients, we have compared epidural analgesia with intravenous patient-controlled analgesia (IVPCA) after either epidural or general anaesthesia. Different bolus doses of opioid (pethidine 10 mg and 20 mg) in the IVPCA group were also compared. Although epidural morphine provided the greatest efficacy (average pain score out of 10 was 1.8 v. 2.9-3.4 for the other groups), IVPCA, especially with a bolus dose of 20 mg, and especially after epidural anaesthesia, provided the greatest patient satisfaction with the least side-effects.
剖宫产术后提供最佳镇痛仍是一项挑战，因为满意的疼痛缓解必须与患者满意度相结合，包括照顾新生儿的能力。在一项对132例患者的前瞻性研究中，我们比较了硬膜外麻醉或全身麻醉后硬膜外镇痛与静脉自控镇痛（IVPCA）的效果。还比较了IVPCA组不同剂量推注阿片类药物（哌替啶10mg和20mg）的情况。虽然硬膜外吗啡的镇痛效果最佳（10分制平均疼痛评分，其他组为2.9 - 3.4分，硬膜外吗啡组为1.8分），但IVPCA，尤其是推注剂量为20mg时，特别是在硬膜外麻醉后，患者满意度最高且副作用最少。
