- 期刊
Comparative Analgesic Enhancement of Alfentanil, Fentanyl, and Sufentanil to Spinal Tetracaine Anesthesia for Cesarean Delivery
以Tetracaine行脊椎麻醉併用Alfentanil，Fentanyl，和Sufentanil對剖腹產病人的止痛效果之評估
摘要
Clinical investigations have shown that intrathecal local anesthetic combined with alfentanil, fentanyl, or sufentanil results in a synergetic interaction that improves perioperative analgesia. However, there are as yet few studies designed to compare equal potency dose of these three 4-anilinopiperidine analogues. This prospective study is an attempt to study the comparative analgesic properties of these three drugs. 156 parturients who had consented to spinal anesthesia for cesarean delivery, were anesthetized with 12mg of tetracaine which was combined with various doses of these three opioids. The addition of these intrathecal opioids significantly improved analgesia. Intra-operatively, 26% of the control group had insufficient analgesia while all patients in the sufentanil or fentanyl groups had sufficient analgesia without needing any analgesic supplementation. Postoperatively 10μg of sufentanil delayed the onset of any postoperative pain from 106 to 286 min. Side effects such as pruritus, respiratory depression, nausea, and vomiting were not different from those of the control group. This study indicates that 10ug sufentanil appears to be better than alfentanil or fentanyl in improving intra-and postoperative analgesia in parturient undergoing hyperbaric tetracaine spinal anesthesia for cesarean section.
並列摘要
臨床研究顯示，脊椎內使用局部麻醉劑併用alfentanil、fentanyl或sufentanil所產生的協同作用可以改善手術期間的疼痛，但很少研究設計來比較這三種藥物的相等強度之劑量。這個回溯性的研究，其目的是比較這三種不同藥物的止痛性質。156個接受剖腹生產，同意做脊椎麻醉的準媽媽，均用12mg的tetracaine併用這三種不同劑量鴉片類藥物麻醉。脊椎內加用鴉片類藥物，非常明顯的改善止痛情形。手術中，控制組有26%發生疼痛的情形，而用sufentail或fentanyl組則無此情況，也不需再加入其它止痛劑。術後10μg的sufentanil可延長術後任何疼痛發生之時間，由106分延長至286分，而且副作用如騷癢、呼吸抑制、噁心和嘔吐等，與控制組沒什麼差別。這個研究指出在剖腹生產接受此種tetracaine脊椎麻醉的產婦用10μg sufentanil較alfentanil或fentanyl更有效的改善術中及術後的疼痛。