Dounas M, O'Kelly B O, Jamali S, Mercier F J, Benhamou D
Département d'Anesthésie-Réanimation, Hôpital, Antoine Béclère, Clamart, France.
Eur J Anaesthesiol. 1996 Nov;13(6):594-8. doi: 10.1046/j.1365-2346.1996.00053.x.
The use of adrenaline added to bupivacaine during epidural analgesia for labour is controversial. The effects of epidural analgesia with bupivacaine containing adrenaline on maternal blood pressure and heart rate, uterine activity, progress of labour, fetal heart rate and Apgar scores, were assessed using visual analogue pain scores, upper level of sensory block and motor blockade in 60 parturients who were allocated randomly to receive: 10 mL of bupivacaine 0.25% plain (group I) or with adrenaline 5 micrograms mL-1 (group II) or with adrenaline 1.66 micrograms mL-1 (group III). The first stage of labour was significantly longer in group II than in group I [414 +/- 49 vs. 296 +/- 24 min (+/- SD)]. There were no other significant differences. It is concluded that adrenaline at 5 micrograms mL-1 significantly prolongs the first stage of labour. Neither adrenaline 5 micrograms mL-1 nor 1.66 micrograms mL-1 has any beneficial effect.
分娩硬膜外镇痛时在布比卡因中添加肾上腺素存在争议。使用视觉模拟疼痛评分、感觉阻滞平面上限和运动阻滞，对60名随机分配接受以下处理的产妇进行评估：10 mL 0.25%普通布比卡因（I组）或含5微克/毫升肾上腺素的布比卡因（II组）或含1.66微克/毫升肾上腺素的布比卡因（III组），以观察含肾上腺素的布比卡因硬膜外镇痛对产妇血压、心率、子宫活动、产程、胎儿心率及阿氏评分的影响。II组第一产程明显长于I组[414±49 vs. 296±24分钟（±标准差）]。无其他显著差异。结论是5微克/毫升肾上腺素显著延长第一产程。5微克/毫升和1.66微克/毫升肾上腺素均无有益作用。
