Liu Z, Tian Y, Zhang C, Jin S
Department of Anaesthesiology, Tongji Hospital, Tongji Medical University, Wuhan.
J Tongji Med Univ. 1997;17(3):172-6. doi: 10.1007/BF02888296.
A clinical study was conducted to compare the analgesic effect of clonidine with those of sumatriptan and their mixture and their effects on hemodynamics. 40 patients undergoing elective total hysterectomy were randomly divided into 4 groups in terms of the epidurally administered drugs with 10 patients in each group (group C1: clonidine 150 micrograms, group C2: clonidine 75 micrograms, group S: sumatriptan 6 mg and group S + C: clonidine 75 micrograms + sumatriptan 3 mg). MAP, HR, SpO2, VT VAS, VRS and ePDT were measured in the initial 4 h. The demographic data and the doses of intraoperative local anesthetics among the 4 groups were not statistically different. It was found that no significant difference in the pre- and postadministration values of HR, SpO2 and VT. A obvious reduction of MAP appeared in the groups of C1 and C2, but in the other groups the hemodynamical parameters were stable. The groups of C1, C2 and S + C showed significant increase in VAS and VRS, along with increase of ePDT when compared with the pre-drug level. There was no obvious alteration in group S after the drug administration. It was concluded that (1) single use of sumatriptan is ineffective in the dose given in this study; (2) small dose (150 micrograms and 75 micrograms) of clonidine has epidurally analgesic effects; (3) combined use of sumatriptan and clonidine is an acceptable way in epidural analgesia, in terms of its analgesic effect and hemodynamic changes.
进行了一项临床研究,比较可乐定与舒马曲坦及其混合物的镇痛效果以及它们对血流动力学的影响。40例行择期全子宫切除术的患者根据硬膜外给药情况随机分为4组,每组10例(C1组:可乐定150微克;C2组:可乐定75微克;S组:舒马曲坦6毫克;S + C组:可乐定75微克+舒马曲坦3毫克)。在最初4小时内测量平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、潮气量(VT)、视觉模拟评分法(VAS)、视觉类比评分法(VRS)和有效痛觉缺失时间(ePDT)。4组患者的人口统计学数据和术中局部麻醉药剂量无统计学差异。结果发现,HR、SpO2和VT给药前后的值无显著差异。C1组和C2组MAP明显降低,但其他组血流动力学参数稳定。与给药前水平相比,C1组、C2组和S + C组的VAS和VRS显著增加,ePDT延长。给药后S组无明显变化。得出以下结论:(1)本研究中给予的剂量下单独使用舒马曲坦无效;(2)小剂量(150微克和75微克)可乐定具有硬膜外镇痛作用;(3)就镇痛效果和血流动力学变化而言,舒马曲坦与可乐定联合使用是硬膜外镇痛的一种可接受方式。