Miwa Y, Yonemura E, Fukushima K
Department of Anaesthesia, Kitasato Institute Hospital, Tokyo, Japan.
Can J Anaesth. 1996 Sep;43(9):907-13. doi: 10.1007/BF03011803.
To study the effect of epidural buprenorphine on minimum alveolar concentration (MAC) of volatile anaesthetics, duration of analgesia and respiratory function in the perioperative period.
One hundred and twenty patients, ASA I-II undergoing gynaecological surgery were randomly divided into three studies. The forty patients in each study were randomly divided into four groups depending on the dosage; Group I (control), Group II (80 micrograms. kg-1 morphine), Group III (4 micrograms. kg-1 buprenorphine), Group IV (8 micrograms. kg-1 buprenorphine). The MAC of halothane was measured following epidural administration of the agents in each group. The duration of analgesia was assessed by the first request for pentazocine. Postoperative analgesic effects were assessed by the total dosage of pentazocine required for the 48 hr after surgery. Respiratory rate (RR), minute volume (MV), and PaCO2 were measured during surgery and the postoperative period. The MAC of halothane was reduced in Group IV (P < 0.01). The duration of analgesia was 10.0 +/- 5.1 hr (Mean +/- SE) in Group I, 37.7 +/- 4.7 hr in Group II, 27.1 +/- 7.1 hr in Group III, and 44.4 +/- 4.1 hr in Group IV. Total dosage of pentazocine was lower in Group IV (P < 0.05) than in the other groups. The decrease of RR, MV and the increase of PaCO2 were observed within 60 min in Group III and IV dose dependently.
Epidural buprenorphine administered in a dose of 4 or 8 micrograms. kg-1 provides postoperative analgesia that is no less effective than that of morphine.
研究硬膜外注射丁丙诺啡对挥发性麻醉药最低肺泡浓度(MAC)、围手术期镇痛持续时间及呼吸功能的影响。
120例拟行妇科手术的ASA I-II级患者随机分为三项研究。每项研究中的40例患者再根据剂量随机分为四组:I组(对照组)、II组(80微克·千克-1吗啡)、III组(4微克·千克-1丁丙诺啡)、IV组(8微克·千克-1丁丙诺啡)。每组患者硬膜外给予相应药物后测量氟烷的MAC。通过首次要求使用喷他佐辛来评估镇痛持续时间。术后镇痛效果通过术后48小时所需喷他佐辛的总剂量来评估。在手术期间及术后测量呼吸频率(RR)、分钟通气量(MV)和动脉血二氧化碳分压(PaCO2)。IV组氟烷的MAC降低(P<0.01)。I组镇痛持续时间为10.0±5.1小时(均值±标准误),II组为37.7±4.7小时,III组为27.1±7.1小时,IV组为44.4±4.1小时。IV组喷他佐辛的总剂量低于其他组(P<0.05)。III组和IV组在60分钟内剂量依赖性地出现RR和MV降低以及PaCO2升高。
硬膜外注射4或8微克·千克-1丁丙诺啡提供的术后镇痛效果不亚于吗啡。