Roulson C J, Bennett J, Shaw M, Carli F
Department of Anaesthesia, Northwick Park Hospital, Harrow, Middlesex.
Br J Anaesth. 1993 Dec;71(6):810-3. doi: 10.1093/bja/71.6.810.
We have examined the efficacy, duration of action and side effects of extradural diamorphine alone and in combination with 1:200,000 adrenaline in a randomized, double-blind controlled study of 45 patients who underwent Caesarean section under spinal anaesthesia. Saline 10 ml, diamorphine 2.5 mg in saline 10 ml or diamorphine 2.5 mg in 1:200,000 adrenaline 10 ml were administered via the extradural route at delivery of the baby. Both diamorphine and diamorphine with adrenaline provided significantly prolonged analgesia compared with control (mean time to next analgesia (95% confidence interval) 17.3 h (12.0, 22.1 h), 15.9 h (10.6, 21.1 h), 5.7 h (1.5, 9.9 h), respectively) (P < 0.01). The addition of adrenaline increased the quality of analgesia 8 h after operation, but had no effect on the total amount of i.m. morphine administered during the first 24 h. The incidence of side effects was similar in all groups.
我们在一项针对45例接受腰麻下剖宫产手术患者的随机双盲对照研究中，考察了硬膜外单独使用二氢吗啡酮以及与1:200,000肾上腺素联合使用的疗效、作用持续时间和副作用。在胎儿娩出时，通过硬膜外途径给予10 ml生理盐水、10 ml生理盐水中含2.5 mg二氢吗啡酮或10 ml含1:200,000肾上腺素的溶液中含2.5 mg二氢吗啡酮。与对照组相比，二氢吗啡酮和二氢吗啡酮加肾上腺素均显著延长了镇痛时间（下次镇痛的平均时间（95%置信区间）分别为17.3小时（12.0，22.1小时）、15.9小时（10.6，21.1小时）、5.7小时（1.5，9.9小时））（P < 0.01）。添加肾上腺素提高了术后8小时的镇痛质量，但对前24小时内肌内注射吗啡的总量没有影响。所有组的副作用发生率相似。
