综上所述,Suf 0.5 μg/ml与0.125%Levob是最佳配伍剂量,具有镇痛效果好、副反应少的优点,可作为妇科术后镇痛的首要选择方案之一。
【参考文献】
[1] Ohmura S, Kawada M, Ohta T,et al.Systemic toxicity and resuscitation in bupivacaine, levobupivacaine,or ropivacaineinfused rats[J]. Anesth Analg,2001,91(3):743748.
[2] Morrison SG, Dominguez JJ, Frascarolo P,et al. A comparison of the electrocardiographic cardiotoxic effects of racemic bupivacaine, levobupivacaine, and ropivacaine in anesthetized swine [J].Anesth Analg,2000,90(6):13081314.
[3] Murdoch JA, Dickson UK, Wilson PA. The efficacy and safety of three concentrations of levobupivacaine administered as a continuous epidural infusion in patients undergoing orthopedic surgery[J].Anesth Analg,2002,94(3):438444.
[4] Wang C,Chakrabarti MK,Whitwam JG.Specific enhancement by fentanyl of the effects of intrathecal bupivacaine on nociceptive afferent but not on sympathetic efferent pathways in dogs[J]. Anesthesiology,1993,79:766773.
[5] Monk JP ,Beresford R ,Ward A. Sufentanil.A review of its pharmacological and therapeutic use[J].Drugs,1998,36:286313.
[6] Menigaux C, Guignard B, Fletcher D,et al. More epidural than intravenous sufentanil is required to provide comparable postoperative pain relief[J]. Anesth Analg,2001,93:472476.
[7] Joris JL, Jacob EA, Sessler DI,et al.Spinal mechanisms contribute to analgesia produced by epidural sufentanil combined with bupivacaine for postoperative analgesia[J]. Anesth Analg,2003 ,97:14461451.
[8] Campbell DC,Camann WR,Datta S,et al.The addition of bupivacaine to intrathecal sufentanil for labor analgesia[J]. Anesth Analg,1995,81:305309.
[9] Solomon RE, Gebhart GF. Synergistic antinociceptive interactions among drugs administered to the spinal cord[J]. Anesth Analg, 1994,78:11641172.
[10] Kaneko M,Saito Y,Kiriharm Y. Synergistic antinociceptive interaction after epidural coadministration of morphine and lidocaine in rats [J].Anesthesiology,1994,80:137150.
[11] Sjostrm S, Hartvig D, Tamsen A. A patientcontrolled analgesia with extradural morphine or pethidine[J]. Br J Anaesth,1988,60: 358366.
[12] Chaney MA. Side effects of intrathecal and epidural opioids[J]. Can J Anaesth,1995,42: 891903.
[13] Gürkan Y, Toker K. Prophylactic ondansetron reduces the incidence of intrathecal fentanylinduced pruritus[J]. Anesth Analg,2002,95:17631766.