Hill D A, McCarthy G, Bali I M
Department of Anaesthetics, Waveney Hospital, Ballymena, N. Ireland.
Anaesthesia. 1995 May;50(5):415-9. doi: 10.1111/j.1365-2044.1995.tb05996.x.
Following induction of epidural analgesia with 0.375% bupivacaine, 120 healthy parturients were randomly assigned in a double blind fashion to one of eight infusion groups. All received 8 ml.h-1 of 0.125% bupivacaine either alone (control group), or with alfentanil at 133, 266 or 400 micrograms.h-1 (groups A1-A3) or with diamorphine at 133, 266, 400 or 533 micrograms.h-1 (groups D1-D4). Significantly longer top-up intervals were achieved with the two highest doses of both alfentanil and diamorphine when compared with bupivacaine alone (p < 0.01), making the minimum effective doses 266 micrograms.h-1 of alfentanil and 400 micrograms.h-1 of diamorphine. Perineal analgesia was better in all the opioid groups compared with the control group (p < 0.05). The intensity of motor block was greater in the control group (p < 0.05). The incidence of pruritus did not differ between groups. The highest dose of diamorphine caused significantly more nausea. No significant neonatal side-effects were demonstrated.
在使用0.375%布比卡因诱导硬膜外镇痛后，120名健康产妇被随机双盲分配到八个输注组中的一组。所有产妇均接受8 ml·h⁻¹的0.125%布比卡因，单独使用（对照组），或与阿芬太尼以133、266或400微克·h⁻¹的剂量联合使用（A1 - A3组），或与二氢吗啡以133、266、400或533微克·h⁻¹的剂量联合使用（D1 - D4组）。与单独使用布比卡因相比，两种阿芬太尼和二氢吗啡的最高剂量均显著延长了追加药物的间隔时间（p < 0.01），阿芬太尼的最小有效剂量为266微克·h⁻¹，二氢吗啡的最小有效剂量为400微克·h⁻¹。与对照组相比，所有阿片类药物组的会阴镇痛效果更好（p < 0.05）。对照组的运动阻滞强度更大（p < 0.05）。各组之间瘙痒的发生率没有差异。二氢吗啡的最高剂量导致明显更多的恶心。未发现明显的新生儿副作用。
