Vercauteren M P, Vandeput D M, Meert T F, Adriaensen H A
University Hospital Antwerp, Edegem, Belgium.
Anaesthesia. 1994 Sep;49(9):767-71. doi: 10.1111/j.1365-2044.1994.tb04447.x.
Sixty patients, scheduled for Caesarean section were randomly allocated to receive by the epidural route in a double-blind fashion one of the following patient-controlled analgesia mixtures for the relief of postoperative pain: sufentanil 2 micrograms.ml-1 in 0.9% sodium chloride, sufentanil 2 micrograms.ml-1 + adrenaline 2.5 micrograms.ml-1, or sufentanil 2 micrograms.ml-1 + clonidine 3 micrograms.ml-1. Patient-controlled analgesia settings were a basal infusion rate of 2.5 ml.h-1, an incremental dose of 2.5 ml, a lockout interval of 10 min and a 1-h limit of 10 ml. Whereas patient demographics and pain scores between the groups were not different, the 24-h consumption of sufentanil was significantly lower in the groups receiving a combination (167.5 SD 45 and 139.1 SD 31.9 micrograms for the adrenaline and clonidine groups respectively) as compared to the plain sufentanil regimen (208.2 SD 38.9 micrograms). Although sufentanil requirements were the lowest in the clonidine admixture group, there were no differences with regard to sedation as compared to the plain sufentanil group. The quality of sleep appeared to be significantly better in the sufentanil/adrenaline group despite a significantly lower degree of sedation and higher incidence of pruritus. Treatment of pruritus with naloxone did not seem to influence the quality of analgesia.
60例计划行剖宫产的患者被随机双盲分配，通过硬膜外途径接受以下一种患者自控镇痛混合剂以缓解术后疼痛：0.9%氯化钠溶液中舒芬太尼2微克/毫升、舒芬太尼2微克/毫升+肾上腺素2.5微克/毫升或舒芬太尼2微克/毫升+可乐定3微克/毫升。患者自控镇痛设置为基础输注速率2.5毫升/小时、追加剂量2.5毫升、锁定时间间隔10分钟和1小时限量10毫升。尽管各组间患者人口统计学特征和疼痛评分无差异，但与单纯舒芬太尼方案（208.2±38.9微克）相比，接受联合用药的组（肾上腺素组和可乐定组舒芬太尼24小时消耗量分别为167.5±45微克和139.1±31.9微克）舒芬太尼消耗量显著更低。尽管可乐定混合剂组舒芬太尼需求量最低，但与单纯舒芬太尼组相比，镇静方面无差异。舒芬太尼/肾上腺素组睡眠质量似乎显著更好，尽管镇静程度显著更低且瘙痒发生率更高。用纳洛酮治疗瘙痒似乎不影响镇痛质量。
