Vercauteren M P, Coppejans H C, ten Broecke P W, Van Steenberge A L, Adriaensen H A
Department of Anesthesiology, University Hospital Antwerp, Edegem, Belgium.
Anesth Analg. 1995 Jan;80(1):76-80. doi: 10.1097/00000539-199501000-00013.
To evaluate the usefulness of a concurrent infusion in patient-controlled epidural analgesia (PCEA), 40 patients scheduled for elective cesarean section under a combined spinal-epidural technique were assigned randomly in a double-blind fashion to receive sufentanil by PCEA with a concomitant infusion of either sufentanil or saline. The sufentanil 24-h consumption was significantly (P < 0.001) higher in those patients receiving the opioid-containing infusion (212.7 +/- 9.5 vs 128.4 +/- 10.8 micrograms, SEM). The number of additional demands and the quality of sleep did not differ between the two groups. The degree of sedation was significantly less pronounced in patients treated with incremental sufentanil doses only. The visual analog scale (VAS) pain scores at rest were identical in both groups except at 6 h (2.5 +/- 0.4 vs 3.7 +/- 0.3, in favor of the patients treated with the sufentanil background infusion). We conclude that, except for a lower pain score during the initial hours, a background infusion in PCEA with sufentanil does not offer major advantages in terms of sleep quality or sufentanil consumption. Side effects may be more pronounced owing to increased drug administration.
为评估在患者自控硬膜外镇痛（PCEA）中同时输注的作用，40例计划在腰麻-硬膜外联合技术下行择期剖宫产的患者，采用双盲法随机分组，接受PCEA输注舒芬太尼，同时分别输注舒芬太尼或生理盐水。接受含阿片类药物输注的患者舒芬太尼24小时消耗量显著更高（P<0.001）（212.7±9.5 vs 128.4±10.8微克，标准误）。两组间额外需求次数和睡眠质量无差异。仅接受递增舒芬太尼剂量治疗的患者镇静程度明显较轻。除6小时外，两组静息时视觉模拟量表（VAS）疼痛评分相同（2.5±0.4 vs 3.7±0.3，舒芬太尼背景输注治疗的患者更优）。我们得出结论，除了最初几小时疼痛评分较低外，PCEA中舒芬太尼背景输注在睡眠质量或舒芬太尼消耗量方面并无主要优势。由于药物给药量增加，副作用可能更明显。
