Marcus M A, Vertommen J D, Van Aken H, Gogarten W, Buerkle H
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälische Wilhelms-Universität, Münster, Germany.
Anesth Analg. 1998 Apr;86(4):749-52. doi: 10.1097/00000539-199804000-00014.
This study was conducted to determine the effects of adding isoproterenol to epidural bupivacaine and sufentanil on the quality and duration of analgesia during labor. In a double blind, randomized study, 80 women were divided into two groups, receiving three doses of 0.125% bupivacaine with 7.5 microg of sufentanil and either 12.5 microg of epinephrine (EPI group) or 5 microg of isoproterenol (ISO group). Contraction pain was measured using a 100-mm visual analog scale (VAS) before epidural analgesia, at 5-min intervals for 15 min after each epidural injection, and hourly thereafter. Overall, no significant differences were observed in VAS scores between the groups. However, in the ISO group, VAS scores at 10 and 15 min after the first and second administration were significantly lower than those in the EPI group. Analgesia after each administration lasted significantly longer in patients who received epinephrine. Because of the limited duration of analgesia in the ISO group, more patients in this group received a fourth epidural administration of 0.125% bupivacaine with epinephrine 1:800,000. In conclusion, the addition of isoproterenol to bupivacaine and sufentanil induces a faster onset of analgesia and reduces the duration of analgesia compared with bupivacaine with sufentanil and epinephrine. Therefore, it is preferable to use isoproterenol only once, as a test dose, after the placement of the epidural catheter.
We analyzed the quality and duration of analgesia in laboring women after they received bupivacaine and sufentanil combined with isoproterenol or epinephrine epidurally. We found that the addition of isoproterenol to bupivacaine and sufentanil induces a faster onset of analgesia and reduces the duration of analgesia.
本研究旨在确定在硬膜外布比卡因和舒芬太尼中添加异丙肾上腺素对分娩镇痛质量和持续时间的影响。在一项双盲随机研究中，80名女性被分为两组，分别接受三剂含7.5微克舒芬太尼的0.125%布比卡因，其中一组添加12.5微克肾上腺素（肾上腺素组），另一组添加5微克异丙肾上腺素（异丙肾上腺素组）。在硬膜外镇痛前、每次硬膜外注射后15分钟内每隔5分钟以及此后每小时，使用100毫米视觉模拟量表（VAS）测量宫缩疼痛。总体而言，两组之间的VAS评分无显著差异。然而，在异丙肾上腺素组中，首次和第二次给药后10分钟和15分钟时的VAS评分显著低于肾上腺素组。接受肾上腺素的患者每次给药后的镇痛持续时间明显更长。由于异丙肾上腺素组的镇痛持续时间有限，该组中更多患者接受了第四次硬膜外注射含1:800,000肾上腺素的0.125%布比卡因。总之，与布比卡因加舒芬太尼和肾上腺素相比，在布比卡因和舒芬太尼中添加异丙肾上腺素可使镇痛起效更快，但会缩短镇痛持续时间。因此，在放置硬膜外导管后，最好仅将异丙肾上腺素作为试验剂量使用一次。
我们分析了分娩女性硬膜外接受布比卡因和舒芬太尼联合异丙肾上腺素或肾上腺素后的镇痛质量和持续时间。我们发现，在布比卡因和舒芬太尼中添加异丙肾上腺素可使镇痛起效更快，但会缩短镇痛持续时间。
