D'Angelo R, Gerancher J C, Eisenach J C, Raphael B L
Department of Anesthesiology, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, USA.
Anesthesiology. 1998 Jun;88(6):1519-23. doi: 10.1097/00000542-199806000-00016.
The purpose of this study was to determine if epidural fentanyl produces analgesia in laboring patients by a primary spinal or supraspinal action.
Fifty-four parturients were randomized to receive epidural 0.125% bupivacaine plus one of three treatments: epidural saline-intravenous saline, epidural fentanyl (20 microg/h)-intravenous saline, or epidural saline-intravenous fentanyl (20 microg/h). The study treatments were administered by continuous infusion, whereas epidural bupivacaine use was patient controlled.
Epidural bupivacaine use was significantly reduced by epidural (11.5+/-4.6 ml/h) but not by intravenous fentanyl (15.9+/-4.5 ml/h) compared with saline control (16+/-5.9 ml/ h). Analgesia characteristics and side effects were similar among groups.
Low-dose epidural infusions of fentanyl produce labor analgesia by a primary spinal action.
本研究的目的是确定硬膜外给予芬太尼是否通过主要的脊髓或脊髓上作用为分娩患者产生镇痛效果。
54名产妇被随机分为接受硬膜外0.125%布比卡因加以下三种治疗之一：硬膜外生理盐水-静脉生理盐水、硬膜外芬太尼（20微克/小时）-静脉生理盐水、或硬膜外生理盐水-静脉芬太尼（20微克/小时）。研究治疗通过持续输注给药，而硬膜外布比卡因的使用由患者自控。
与生理盐水对照（16±5.9毫升/小时）相比，硬膜外给予芬太尼（11.5±4.6毫升/小时）可显著减少硬膜外布比卡因的使用，但静脉给予芬太尼（15.9±4.5毫升/小时）则无此效果。各组间镇痛特征和副作用相似。
低剂量硬膜外输注芬太尼通过主要的脊髓作用产生分娩镇痛效果。
