Vertommen J D, Marcus M A, Van Aken H
Department of Anesthesiology, University Hospitals, Katholieke Universiteit Leuven, Belgium.
Anesth Analg. 1995 Jan;80(1):71-5. doi: 10.1097/00000539-199501000-00012.
This study examines the placental transfer and hemodynamic and acid-base changes after intravenous (i.v.) and epidural administration of sufentanil in the chronically instrumented maternal-fetal sheep preparation. A dose of 50 micrograms sufentanil was injected either i.v. or epidurally into seven ewes. Neither i.v. nor epidural injection of sufentanil affected maternal mean arterial pressure (MMAP), uterine blood flow (UBF), maternal heart rate (MHR), fetal mean arterial pressure (FMAP), fetal heart rate (FHR), or blood gases and acid-base status in mother and fetus, After i.v. administration, a peak sufentanil level of 1.28 ng/mL +/- 0.285 (SD) was detected in maternal plasma. A peak plasma level of 0.037 ng/mL +/- 0.041 (SD) was attained in the fetus. A constant maternal-fetal concentration ratio of 5.5 from 15-60 min after the i.v. injection was found. After epidural injection a mean peak plasma level of 0.059 ng/mL +/- 0.042 (SD) was reached in the mother 25 min after injection. Sufentanil levels were undetectable in fetal plasma after epidural injection into the mother. Because placental transfer of sufentanil is small, the maternal and fetal cardiovascular and acid-base effects are minimal in the pregnant ewe.
本研究在长期植入监测仪器的母胎绵羊模型中，考察了静脉注射（i.v.）和硬膜外注射舒芬太尼后的胎盘转运以及血流动力学和酸碱变化。向7只母羊静脉注射或硬膜外注射50微克舒芬太尼。静脉注射和硬膜外注射舒芬太尼均未影响母体平均动脉压（MMAP）、子宫血流量（UBF）、母体心率（MHR）、胎儿平均动脉压（FMAP）、胎儿心率（FHR），以及母体和胎儿的血气及酸碱状态。静脉注射后，母体血浆中舒芬太尼的峰值水平为1.28纳克/毫升±0.285（标准差）。胎儿血浆中达到的峰值水平为0.037纳克/毫升±0.041（标准差）。静脉注射后15至60分钟，母体与胎儿的浓度比恒定为5.5。硬膜外注射后，母体在注射后25分钟达到的平均血浆峰值水平为0.059纳克/毫升±0.042（标准差）。向母体硬膜外注射后，胎儿血浆中未检测到舒芬太尼水平。由于舒芬太尼的胎盘转运量较小，其对妊娠母羊母体和胎儿心血管及酸碱的影响极小。
