Pellegrini J E
Naval School of Health and Sciences, Nurse Anesthesia Program, US Naval Medical Center, Portsmouth, VA 23708, USA.
CRNA. 1998 Aug;9(3):99-105.
Since the discovery of opiate receptors in the brain and spinal cord, considerable research has been performed to include intrathecal opioids for the control of pain. No area has used this knowledge more than the practice of obstetrical anesthesia. Intrathecal opioids have been shown to be very effective in controlling the pain experienced in the first stage of labor but have been ineffective in controlling second-stage labor pain. Intrathecal opioids, especially morphine sulfate, provide long-term analgesia but are associated with a high number of side effects. Research studies have attempted to determine the optimal dose of intrathecal opioids to provide the greatest amount of analgesia with the lowest incidence of side effects. Intrathecal morphine sulfate has been shown to be effective in controlling first-stage labor pain but has been shown to be the most efficacious in controlling the pain experienced in the post-cesarean section period. This article reviews the current literature and provides background of information to understand these developments.
自从在大脑和脊髓中发现阿片受体以来，人们进行了大量研究，将鞘内注射阿片类药物用于疼痛控制。在产科麻醉实践中，没有哪个领域比这更能运用这一知识了。鞘内注射阿片类药物已被证明在控制第一产程疼痛方面非常有效，但在控制第二产程疼痛方面却无效。鞘内注射阿片类药物，尤其是硫酸吗啡，可提供长期镇痛效果，但会伴有大量副作用。研究试图确定鞘内注射阿片类药物的最佳剂量，以在副作用发生率最低的情况下提供最大程度的镇痛效果。硫酸吗啡鞘内注射已被证明在控制第一产程疼痛方面有效，但在控制剖宫产术后疼痛方面最为有效。本文回顾了当前文献，并提供相关背景信息以了解这些进展。
