Oda A, Ishiyama T, Suzuki A, Okumura Y, Dohi S
Department of Anesthesiology and Critical Care Medicine, Gifu University School of Medicine.
Masui. 1996 Dec;45(12):1511-5.
We studied the effects of continuous epidural administration of fentanyl and morphine with bupivacaine for management of postcesarean pain. Eighteen patients received either bolus epidural administration of fentanyl 100 micrograms or morphine 3 mg with 0.5% bupivacaine 4 ml, followed by continuous infusion of fentanyl 33 micrograms.ml-1 with 0.17% bupivacaine or morphine 0.21 mg.ml-1 with 0.17% bupivacaine for 48 hours, respectively. Pain score was assessed at 0 h, 12h, 24h and 48h after leaving the operating room. Pain score increased significantly and progressively in the fentanyl group. In all cases pruritus was noted. Severe pruritus was observed in the morphine group significantly more than in the fentanyl group. The current results indicate that morphine may be preferable to fentanyl for postcesarean pain control using the present opioid doses.
我们研究了芬太尼和吗啡与布比卡因持续硬膜外给药用于剖宫产术后疼痛管理的效果。18例患者分别接受硬膜外推注100微克芬太尼或3毫克吗啡加4毫升0.5%布比卡因,随后分别持续输注33微克·毫升⁻¹芬太尼加0.17%布比卡因或0.21毫克·毫升⁻¹吗啡加0.17%布比卡因,持续48小时。在离开手术室后0小时、12小时、24小时和48小时评估疼痛评分。芬太尼组疼痛评分显著且逐渐增加。所有病例均出现瘙痒。吗啡组严重瘙痒的发生率显著高于芬太尼组。目前的结果表明,使用当前阿片类药物剂量时,吗啡在控制剖宫产术后疼痛方面可能优于芬太尼。