Shiraishi Y, Sakai S, Yokoyama J, Hayatsu K, Mochizuki T, Moriwaki G, Mizutani A
Department of Anesthesia, Shizuoka General Hospital.
Masui. 1993 Mar;42(3):371-5.
We investigated 27 patients undergoing elective surgery under epidural anesthesia. The plasma concentration of buprenorphine during its continuous epidural administration was measured by the radioimmunoassay method. We also performed a retrospective study on supplemental analgesics necessary for 48 hours after surgeries. The plasma concentration of buprenorphine was found to be stable at 300 pg.ml-1 during its continuous epidural infusion. The frequencies of administration of supplemental analgesics were 3.3 times with catheterization at upper thoracic vertebral level, 2. 1 times at lower thoracic vertebral level and 1.7 time at upper lumbar vertebral level. We conclude that analgesia with the continuous epidural administration of buprenorphine is satisfactory at low plasma concentration and is superior, considering the necessity of supplemental analgesics to other methods of systemic administration. It is estimated that the epidural distribution volume at lower thoracic and upper lumbar vertebral level is twice the volume at upper thoracic level from plasma buprenorphine concentration.
我们研究了27例接受硬膜外麻醉下择期手术的患者。采用放射免疫分析法测定布托啡诺持续硬膜外给药期间的血浆浓度。我们还对术后48小时所需的辅助镇痛药进行了回顾性研究。结果发现，布托啡诺持续硬膜外输注期间，其血浆浓度稳定在300 pg.ml-1。在上胸椎水平置管时辅助镇痛药的使用频率为3.3次，在下胸椎水平为2.1次，在上腰椎水平为1.7次。我们得出结论，布托啡诺持续硬膜外给药在低血浆浓度时镇痛效果良好，且从辅助镇痛药的必要性来看，优于其他全身给药方法。根据血浆布托啡诺浓度估计，下胸椎和上腰椎水平的硬膜外分布容积是上胸椎水平的两倍。
