Norris M C, Fogel S T, Holtmann B
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Reg Anesth Pain Med. 1998 May-Jun;23(3):252-7. doi: 10.1016/s1098-7339(98)90050-5.
Despite growing popularity, there are few studies examining the relative efficacy of different doses of intrathecal sufentanil for labor analgesia. This prospective, randomized, double-blind study compared the efficacy and side effects of 5 and 10 microg intrathecal sufentanil.
Sixty-three healthy, laboring, term parturients < or =5 cm cervical dilation participated in this study. In a randomized, double-blind fashion, patients received 5 or 10 microg intrathecal sufentanil as part of a combined spinal epidural technique. Patients rated pain, itching, nausea, and sedation on verbal analog scales before and every 10 minutes after drug injection. We also recorded maternal blood pressure and peripheral oxygen saturation before and every 10 minutes after drug injection. Before and 30 and 60 minutes after drug injection, we measured maternal end-tidal CO2.
Both doses of sufentanil provided adequate analgesia. Although 10 microg sufentanil produced slightly more profound analgesia, the duration of pain relief did not differ between the two groups. Both drug doses were associated with significant increases in itching and end-tidal CO2. The 10-microg dose was associated with more sedation and a greater decrease in SaO2.
Both 5 and 10 microg intrathecal sufentanil provided adequate labor analgesia. Both doses were associated with measurable spinal (itching) and supraspinal (sedation, respiratory depression) side effects.
尽管鞘内注射舒芬太尼越来越受欢迎，但很少有研究比较不同剂量鞘内注射舒芬太尼用于分娩镇痛的相对疗效。这项前瞻性、随机、双盲研究比较了5微克和10微克鞘内注射舒芬太尼的疗效及副作用。
63例宫颈扩张≤5cm的健康足月分娩产妇参与了本研究。患者以随机、双盲方式接受5微克或10微克鞘内注射舒芬太尼，作为联合腰麻硬膜外麻醉技术的一部分。患者在注药前及注药后每10分钟用视觉模拟评分法对疼痛、瘙痒、恶心和镇静程度进行评分。我们还记录了产妇注药前及注药后每10分钟的血压和外周血氧饱和度。在注药前、注药后30分钟和60分钟测量产妇的呼气末二氧化碳分压。
两种剂量的舒芬太尼均提供了充分的镇痛效果。虽然10微克舒芬太尼产生的镇痛作用稍强，但两组的疼痛缓解持续时间无差异。两种药物剂量均与瘙痒和呼气末二氧化碳分压显著升高有关。10微克剂量与更多的镇静作用及动脉血氧饱和度更大幅度下降有关。
5微克和10微克鞘内注射舒芬太尼均能提供充分的分娩镇痛。两种剂量均与可测量的脊髓（瘙痒）和脊髓以上（镇静、呼吸抑制）副作用有关。
