亚睡眠剂量异丙酚对小鼠痛阈的影响

目的：观察亚睡眠剂量的异丙酚对小鼠痛阈的影响。方法：ＮＩＨ小鼠１２０只，随机分为８组（每组１５只）即：对照组，注射０．９％生理盐水１０ｍｌ／ｋｇ（ＮＳ组），１０％脂肪乳剂１０ｍｌ／ｋｇ（Ｉ组），异丙酚组，注射异丙酚２．５ｍｇ／ｋｇ（Ｐ１组），５ｍｇ／ｋｇ（Ｐ２组），１０ｍｇ／ｋｇ（Ｐ３组）硫喷妥钠组，分别注射与异丙酚求证射。痛阈测定采用ＣＯ２激光痛阈测定法，结果：（１）１组与ＮＳ组比较，小鼠痛阈没     

脊髓阿片受体在异丙酚对大鼠抗伤害性效应中的作用

目的 探讨脊髓阿片受体在异丙酚对大鼠抗伤害性效应中的作用.方法 雄性SD大鼠,体重220～280 g,选取鞘内置管成功的大鼠90只,随机分为9组(n=10):P组、D组和A组分别鞘内注射异丙酚10μg、二甲基亚砜(DMSO)5μl,人工脑脊液5μl;PN组和DN组分别鞘内注射异丙酚10μg、DMSO 5μl,5 min后均鞘内注射纳洛酮15 μg;PC组和DC组分别鞘内注射异丙酚10 μg、DMSO 5 μl,5 min后均鞘内注射高选择性μ受体拮抗剂CTOP 1 μg,PI组和DI组分别鞘内注射异丙酚10μg和DMSO 5 μl,5 min后均鞘内注射高选择性δ受体拈抗剂ICI 174,864 1μg.于首次给药前(T0)、首次给药后10 min(T1)、20 min(T2)、40 min(T3)时采用热水缩尾法测定痛阈,并计算痛阈提高百分率.结果 与T0时比较,T1,2时P组、PN组、PI组和PC组痛阈升高(P<0.05);P组痛阈高于D组,PN组痛阈高于DN组,PI组痛阈高于DI组,PC组痛阈高于DC组(P<0.05);与T1和T2时比较,T3时P组、PN组、PC组和PI组痛阈提高百分率降低(P<0.05);与P组和PC组比较,PN组和PI组首次给药后痛阈提高百分率降低(P<0.05).结论 异丙酚通过大鼠脊髓δ受体介导产生抗伤害性效应.     

脊髓水平GABAA受体在异丙酚对内脏痛大鼠镇痛效应中的作用

目的 探讨脊髓水平γ-氨基丁酸（GABA）A受体在异丙酚对内脏痛大鼠镇痛效应中的作用。方法 35只雄性SD大鼠，体重180—240g，随机分为5组，每组7只，腹腔注射生理盐水0．5ml组（C组），腹腔注射异丙酚10mg／kg组（P1组），腹腔注射异丙酚20mg/kg组（P2组），鞘内注射荷包牡丹碱0．25馏组（B组），鞘内注射荷包牡丹碱0．25μg＋腹腔注射异丙酚10mg/kg组（BP组）。采用结直肠扩张法制备内脏痛动物模型，以腹壁明显收缩变平的最小扩张压力值为痛阈，观察给药前即刻（T0）及给药后5min（T1）、10min（T2）、15min（T3）、20min（T4）、25min（T5）、30min（k）、40min（B）、50min（T8）大鼠的痛阈，并计算最大镇痛效应百分率（MPE）。结果 与C组比较，P1组T1-4时、P2组T1-5，时的痛阈升高（P〈0．05或0．01）；与P1组比较，P2组痛阈升高（P〈0．01）。与P1组比较，B组T1-4时MPE降低，BP组T2-4时MPE升高（P〈0．05或0．01）；与B组比较，BP组，T1-4时MPE升高（P〈0．05或0．01）。结论 异丙酚部分通过介导脊髓水平GABAA受体，对大鼠结直肠扩张所致内脏痛具有镇痛作用。     

异丙酚对大鼠内脏抗伤害作用与中枢γ-氨基丁酸受体A受体的关系

目的探讨异丙酚对大鼠内脏抗伤害作用与中枢γ-氨基丁酸受体A（BABAA）的关系。方法49只雄性SD大鼠，体重180～240g，随机均分为7组：腹腔异丙酚10mg／kg体重组（Pi．P．）、侧脑室荷包牡丹碱0．25μg组（Bici．c-v．）、脊髓蛛网膜下腔荷包牡丹碱0．25μg组（Bici．t．）、侧脑室与脊髓蛛网膜下腔荷包牡丹碱各0．125μg组（Bici．c．v．／i．t．）、侧脑室预注荷包牡丹碱0．25μg＋腹腔异丙酚10mg／kg体重组（Bici．c．v．＋Pi．P．）、脊髓蛛网膜下腔预注荷包牡丹碱0．25μg＋腹腔异丙酚10mg／kg体重组（Bici．t．＋Pi．P．）、侧脑室与脊髓蛛网膜下腔预注荷包牡丹碱各0．125μg＋腹腔异丙酚10mg／kg体重组（Bici．c．v．／i．t．＋Pi．P．）。侧脑室或／和脊髓蛛网膜下腔预注荷包牡丹碱后10min腹腔给药。采用结直肠扩张内脏痛模型，以腹壁明显收缩变平的最小扩张压力值为痛阈，观察给药前及给药后各时间点的大鼠痛阈变化。结果腹腔注射异丙酚10mg／kg体重，5min后结直肠扩张痛阈显著提高（P〈0．05，P〈0．01），10～15min达高峰，持续20min；侧脑室、脊髓蛛网膜下腔或侧脑室＋脊髓蛛网膜下腔预注荷包牡丹碱后结直肠扩张痛阈均无明显变化（P〉0．05）；侧脑室、脊髓蛛网膜下腔或侧脑室＋脊髓蛛网膜下腔预注荷包牡丹碱后10min腹腔注射异丙酚10mg／kg体重，3组给药后5～20min内结直肠扩张痛阈也均有提高，但其增高值均明显低于Pi．p．组（P〈0．05，P〈0．01）；且这3组之间最大镇痛效应差异无统计学意义（P〉0．05）。结论侧脑室、脊髓蛛网膜下腔、侧脑室＋脊髓蛛网膜下腔预注荷包牡丹碱，均可部分拮抗异丙酚的内脏抗伤害作用，因而异丙酚的内脏抗伤害作用受脊髓与脊髓上中枢γ-氨基丁酸A受体介导。     

大鼠结直肠扩张内脏痛模型痛阈的影响因素

结直肠扩张(Colorectal distension，CRD)作为伤害性刺激诱发的内脏痛模型是许多内脏痛研究的依据。动物痛阈测定易受气温、湿度、昼夜节律、饥饿状态、动物种系、性别与周龄等多种因素的影响。而对于影响结直肠扩张大鼠模型痛阈的主要因素，以及它们对内脏痛痛阈影响的程度，国内外尚未定论。本研究拟观察不同气囊长度、性别及体重对结直肠扩张内脏痛模型痛阈的影响，找出痛阈的主要影响因素，以减少实验误差。     

大鼠结直肠扩张内脏痛模型的建立与行为学评价

目的 评估腹壁撤回反射(AWR)评分用于评价大鼠结直肠扩张内脏痛动物模型的行为反应及可靠性。方法 大鼠经肛门插入扩张气囊,注气扩张结直肠建立急性内脏痛动物模型。采用腹壁撤回反射评分评估大鼠受伤害性刺激而出现的行为反应强度,并测定 AWR 3分的最小压力值(痛阈)。结果 大鼠结直肠扩张后100％出现腹壁撤回反射,扩张压力越高,其评分越高,扩张压力 15、25、40、60 mm Hg(1mm Hg=0.133 kPa)产生的 AWR评分相互比较差异均有显著性(P<0.05);首次扩张的痛阈较高,3次扩张后稳定,其平均痛阈为(27.68±2.59)mm Hg,5、10 d后重复扩张痛阈无明显变化;吗啡皮下注射呈剂量依赖提高大鼠结直肠扩张的痛阈,其作用可被纳洛酮完全拮抗。结论 腹壁撤回反射评分可评价大鼠结直肠扩张的刺激强度,其中 AWR 3分指标明确,测定的痛阈值稳定;该模型及其行为学评分具有无创伤、稳定性好、重复性强、可定量的特点,可用于内脏痛及镇痛药的有关研究。     

异丙酚对异相睡眠剥夺大鼠海马谷氨酸和γ-氨基丁酸释放的影响

目的 探讨异丙酚对24 h异相睡眠剥夺大鼠海马谷氨酸(Glu)和γ-氨基丁酸(γ-GABA)释放的影响.方法 健康雄性SD大鼠16只,成功完成24 h异相睡眠剥夺实验后,随机分为2组(n=8),自然睡眠组(N组)腹腔注射5%脂肪乳剂3 ml,异丙酚组(P组)腹腔注射异丙酚100mg/kg.于异相睡眠剥夺前(基础状态)、异相睡眠剥夺24 h时(T1)、异相睡眠剥夺结束后1 h(T2)、3 h(T3)和6 h(T4)收集2组海马微透析液,检测Glu和γ-GABA的浓度.结果 与基础值比较,N组和P组T1-3时海马微透析液内Glu、γ-GABA浓度升高,N组T4时上述指标仍较高;与T1时比较,N组和P组T3,4时上述指标降低(P＜0.05或0.01).两组间Glu、γ-GABA浓度差异无统计学意义(P＞0.05).结论 异丙酚麻醉对大鼠异相睡眠剥夺时海马内紊乱的Glu和γ-GABA递质有恢复作用,其作用与自然睡眠相似.     

不同剂量异丙酚对顺铂致大鼠肝细胞毒性的影响

目的 评价不同剂量异丙酚对顺铂致大鼠肝细胞毒性的影响.方法 健康雄性SD大鼠80只,体重200 ～ 250 g,3月龄,采用随机数字表法,将其随机分为8组(n=10)∶对照组(C组)、顺铂7.5 mg/kg组(Cis组)、异丙酚180 mg/kg组(P组)、脂肪乳15 ml/kg组(Ⅰ组)、顺铂7.5 mg/kg+脂肪乳15ml/kg组(CisI组)、顺铂7.5 mg/kg+异丙酚60 mg/kg组(CisP1组)、顺铂7.5 mg/kg+异丙酚120 mg/kg组(CisP2组)、顺铂7.5 mg/kg+异丙酚180 kg/mg组(CisP3组).每组均按体重予腹腔注射,C组、Cis组、P组和Ⅰ组分别单次注射生理盐水、顺铂、异丙酚和脂肪乳剂.CisI组、CisP组、CisP2组和CisP3组于注射异丙酚或脂肪乳剂后1 min注射顺铂.注射顺铂后24 h,采集下腔静脉血,全自动生化分析仪检测血浆谷丙转氨酶(ALT)及谷草转氨酶(AST)活性,取肝组织,于光镜下观察肝组织病理学结果.结果 与C组比较,Cis组、CisI组、CisP1-3组血浆ALT和AST活性升高(P＜0.05),肝组织病理学损伤加重;Cis组、CisP1-3组血浆ALT和AST活性依次降低(P＜0.05),肝组织病理学损伤减轻.结论 异丙酚可呈剂量依赖性地减轻顺铂致大鼠肝细胞毒性.     

不同剂量异丙酚麻醉对新生大鼠远期认知功能的影响

目的 探讨不同剂量异丙酚麻醉对新生大鼠远期认知功能的影响.方法 雄性SD大鼠100只,出生后7d,体重9～18g,采用随机数字表法,将大鼠随机分为5组(n =20)∶对照组(C组)、异丙酚25 mg/kg组(P1组)、异丙酚50 mg/kg组(P2组)、异丙酚100 mg/kg组(P3组)和异丙酚200 mg/kg组(P4组).P1组和P2组分别腹腔注射异丙酚25和50 mg/kg;P3组和P4组首次注射异丙酚50 mg/kg,翻正反射恢复时,再追加异丙酚50 mg/kg,直至给完总量.每组取5只大鼠,于苏醒后即刻抽取动脉血样进行血气分析.苏醒后放回笼内继续饲养直至9周龄,采用Morris水迷宫实验测定认知功能,处死后,取海马组织,分别采用Western blot法和RT-PCR法测定神经生长因子(NGF)和Caspase-9蛋白及其mRNA的表达;电镜下观察海马神经元超微结构.结果 5组大鼠血气分析指标差异无统计学意义(P＞0.05).与C组比较,P1组逃避潜伏期和穿越原平台次数差异无统计学意义(P＞0.05),P2组～P4组逃避潜伏期延长,穿越原平台次数减少,P1组～P4组海马NGF蛋白及其mRNA表达下调,Caspase-9蛋白及其mRNA表达上调(P＜0.05);P1组～P4组逃避潜伏期逐渐延长,NGF蛋白及其mRNA表达逐渐下调,Caspase-9蛋白及其mRNA表达逐渐上调,P2组～P4组穿越原平台次数少于P1组(P＜0.05),但P2组～P4组间差异无统计学意义(P＞0.05);P2组～P4组海马神经元出现核固缩、染色质边集、核碎裂、凋亡小体.结论 异丙酚麻醉可损害新生大鼠的远期认知功能,且该作用与剂量有关;其机制可能与抑制NGF表达,增强Caspase-9活性有关.     

异丙酚对皮质酮抑制体外培养大鼠海马神经前体细胞增殖的影响

目的 评价异丙酚对皮质酮抑制体外培养大鼠海马神经前体细胞增殖的影响及其与GABAA受体表达的关系。方法 体外培养大鼠海马神经前体细胞,第二代生长良好的细胞随机分为10组：空白对照组（Con组）、异丙酚0．5μmol/L组（P1组）、异丙酚2．5μmol/L组（P2组）、皮质酮100μmol/L组（Cort组）、荷包牡丹碱10μmol/L组（Bic组）、皮质酮和异丙酚0．5μmol/L组（CP1组）、皮质酮和异丙酚2．5μmol/L组（CP2组）、皮质酮、荷包牡丹碱和异丙酚0．5μmol/L组（BCP1组）、皮质酮、荷包牡丹碱和异丙酚2．5μmol/L组（BCP2组）、皮质酮和荷包牡丹碱组（BC组）。建立皮质酮抑制细胞增殖模型,利用噻唑蓝法和胸腺嘧啶核苷掺人法观察体外培养大鼠海马神经前体细胞的增殖。采用免疫细胞化学方法鉴定海马神经前体细胞GABAA受体的表达;采用ELISA法定量观察海马神经前体细胞表面GABAA受体表达。结果 异丙酚（0．5、2．5μmol/L）可以减轻皮质酮引起的大鼠海马神经前体细胞增殖的抑制作用,荷包牡丹碱可完全拮抗其作用。海马神经前体细胞有GABAA受体的表达,皮质酮100μmol/L可以使海马神经前体细胞GABAA受体表达下调（P＜0．05）,异丙酚可以阻断皮质酮的效应。结论 低浓度异丙酚可以减轻皮质酮引起的体外培养大鼠海马神经前体细胞增殖的抑制作用,可能与异丙酚激活GABAA受体有关。     

Systemic Naloxone Infusion May Trigger Spasticity in Patients With Spinal Cord Injury: Case Series

Abstract

Background/Objective: Three patients with spinal cord injury (SCI) and 3 able-bodied (AB) patients were infused with naloxone during a study to examine their neuroendocrine function. An unanticipated side effect occurred during the naloxone infusion. All 3 patients with SCI, but none of the AB patients, experienced profoundly increased spasticity during the naloxone infusion. Our report describes this side effect, which has potential implications for the clinical treatment or scientific evaluation of individuals with SCI.

Methods: All patients were in good general health and medication free for 11 days or longer before the study. Each patient was placed on a 30-hour protocol to analyze pulsatile release of gonadotropins. Physiologic saline was intravenously infused on day 1 to serve as a control period for naloxone infusion on day 2.

Results: AB patients experienced no muscle spasm activity or any other side effects at any time during the study. In contrast, all 3 patients with SCI experienced a profoundly increased frequency and duration of spasticity in muscles innervated by the nerve roots caudal to their level of injury. In all 3 patients with SCI, spasticity increased only during the period of naloxone infusion. Within 1 hour of stopping naloxone, spasticity returned to baseline levels.

Conclusions: Naloxone infusion produced a differential effect on the muscle activity of men with SCI compared to AB men with intact spinal circuits. Consistent with previous studies, the results of this study indicate a relationship between opioid neuromodulation and spasticity after SCI.     

脊髓电刺激术治疗内脏痛的研究进展

背景 脊髓电刺激术(spinal cord stimulation,SCS)可以缓解多种原因导致的疼痛,改善器官功能,尤其对于神经病理性疼痛和周围血管病变引起的缺血性疼痛的治疗作用明显.最近研究发现,其对内脏痛性疾病也有艮好的缓解作用.目的 通过综述SCS在内脏痛中的应用及其作用机制,为内脏痛的治疗提供参考. 内容 SCS的发展及其对内脏痛的镇痛机制,对各种内脏痛相关疾病的治疗效应和进展. 趋向 SCS可以治疗药物治疗效果欠佳的内脏痛疾病,为内脏痛的治疗提供新的工具.     

异丙酚对大鼠急性心肌缺血性内脏痛的镇痛作用

目的探讨异丙酚对大鼠心肌缺血性内脏痛的镇痛作用。方法健康成年雄性SD大鼠,实验分两部分。第一部分：将找到丘脑束旁核伤害性刺激反应神经元(NSRN)且对冠状动脉结扎(CAO)敏感的大鼠24只随机分为4组(n=6)：CAO+生理盐水组(CAO组)；P_(0．02)组：CAO+0．02 mg·kg~(-1)异丙酚；P_(0．2)组：CAO+0．2 mg·kg~(-1)异丙酚；P_2组：CAO+2 mg·kg~(-1)异丙酚,每只大鼠记录1个NSRN。异丙酚用生理盐水稀释到0．1 ml,在CAO后15 min尾静脉注射。整个实验从CAO开始连续记录NSRN放电频率60min；第二部分,6只大鼠尾静脉注射异丙酚2mg·kg~(-1)后观察对大鼠的麻醉效果。结果异丙酚(0．2、2mg·kg~(-1))能明显抑制CAO引起的NSRN放电频率的增加(P＜0．05),2 mg·kg~(-1)作用更明显,且该剂量的异丙酚对大鼠无麻醉作用。结论亚麻醉剂量的异丙酚对大鼠急性心肌缺性内脏痛具有一定的镇痛作用,且呈剂量依赖性。     

Effects of morphine on visceral nociception evoked by colorectal distension in rats: comparative examinations of electrophysiological and behavioral responses

The purpose of this study was to compare the effects of intravenously administered morphine on electrophysiological and behavioral responses to colorectal distension (CRD) and to examine the influence of noxious stimuli applied to another part of the body (a laminectomy) on the visceromotor response to CRD. The effects of morphine (0.1–6.4 mg·kg⁻¹) were examined in rate anesthetized with pentobarbital. Electrophysiological (n=16) and behavioral experiments (n=47) were done. Electrophysiological experiments were conducted to examine the effects of morphine on the responses of visceral dorsal horn neurons to CRD; behavioral studies were conducted to compare the effects of morphine with and without a laminectomy (intact group:n=24; laminectomy group:n=23). Morphine suppressed the evoked activities of the visceral dorsal horn neurons in a dose-dependent manner. Similar suppression of the behavioral visceromotor response was observed. Visceromotor thresholds were significantly lower in the intact group than in the laminectomy group during the control study. When morphine was administered, the visceromotor thresholds in both groups increased to a similar level. Behavioral and neurophysiological responses to CRD were suppressed in a similar fashion by morphine. Although laminectomy affected the threshold values of CRD for visceromotor responses, the laminectomy per se plays an insignificant role when adequate morphine is administered. This abstract was presented at the 7th World Congress on Pain     

纳洛酮和丹参合用对感染性休克兔的肺保护作用

目的 :观察纳洛酮和丹参合用处理兔感染性休克模型后的循环、代谢及肺标本的光镜和电镜下的病理改变。方法 :选择 30只健康家兔 ,随机分为五组 ,通过结扎盲肠末端并造成穿孔 ,复制与临床类似的家兔感染性休克模型后 ,给予相应的治疗。 4小时后经颈总动脉置管测MAP ,并抽血测定乳酸盐、丙二醛及动脉血气 ;18小时后活杀动物取肺标本。结果 :纳洛酮组、纳洛酮丹参合用组可明显地升高MAP ,并可明显降低休克模型的血乳酸盐、花生四烯酸的代谢产物丙二醛的水平。治疗组的肺水含量明显低于对照组。光镜见纳洛酮丹参合用组的肺淤血较轻 ,炎细胞浸润亦明显轻于对照组及纳洛酮组。电镜观察见该组的线粒体膜仍保持完好 ,未见破裂或空泡化 ;而对照组及纳洛酮组的线粒体膜则有明显的断裂、解体及线粒体的空泡化。结论 :纳洛酮或纳洛酮丹参合用均可明显改善感染性休克的代谢变化 ,保护脏器功能。因此纳洛酮和丹参合用在改善肺组织的病理形态学方面远较单纯纳洛酮为好 ,疗效更佳     

脊髓GABAA受体在异丙酚对内脏痛大鼠镇痛效应中的作用

目的 评价脊髓γ-氨基丁酸A(GABAA)受体在异丙酚对内脏痛大鼠镇痛效应中的作用.方法成年健康雌性SD大鼠,体重190～240 g,进行鞘内置管,并于直肠粘膜下注射10%福尔马林100 μl.取鞘内置管成功的大鼠32只,采用随机数字表法,将其随机分为4组(n=8):二甲基亚砜组(D组)、异丙酚组(P组)、荷包牡丹碱组(B组)和荷包牡丹碱+异丙酚组(BP组).D组、P组和B组分别鞘内注射二甲基亚砜5 μl、异丙酚10 μg、荷包牡丹碱2 μg;BP组先鞘内注射荷包牡丹碱2 μg,10min后鞘内注射异丙酚10 μg.注射福尔马林2 h时,取脊髓L5～S1节段,采用免疫组化法测定FOS蛋白表达水平.结果 与D组和B组比较,P组脊髓FOS蛋白表达下调(P＜0.05);D组和B组脊髓FOS蛋白表达差异无统计学意义(P＞0.05);与P组比较,BP组脊髓FOS蛋白表达上调(P＜0.05).结论 异丙酚可通过脊髓GABAA受体介导,对内脏痛大鼠产生镇痛效应.

Abstract：

Objective To evaluate the role of spinal cord CABAA receptors in the analgesic effect of propofol on visceral pain in rats. Methods Adult female SD rats, weighing 190-240 g, were used in this study.The animals were anesthetized with intraperitoneal ketamine 50-100 mg/kg. Intrathecal (IT) catheters were placed at L5-6 interspace according to the technique described by Storkson et al. Thirty-two animals in which IT catheters were successfully placed were randomly divided into 4 groups ( n = 8 each) : dimethyl sulphoxide (DMSO) group (group D), propofol group (group P), bicuculline group (group B) and bicuculline + propofol group (group B +P). Visceral pain was induced by injecting 10% formalin 100 μl underneath the mucous membrane of rectum.Groups D, P and B received IT DMSO 5 μl, propofol 10 μg and bicuculline 2 μg respectively. Group BP received IT bicuculline 2 μg and then IT propofol 10 μg 10 min later. The L5-S1 segment of the spinal cord was removed 2 h after formalin injection to determine FOS protein expression by hnmuno-histochemistry. Results Compared with groups D and B, FOS protein expression was significantly down-regulated in group P ( P ＜ 0.05 ) . There was no significant difference in FOS protein expression between groups D and B ( P ＞ 0.05) . FOS protein expression was significantly up-regulated in group BP compared with group P ( P ＜ 0.05) . Conclusion Propofol has analgesic effect on visceral pain in rats through spinal cord GABAA receptor action.     

Effects of epidural fentanyl and intravenous flurbiprofen for visceral pain during cesarean section under spinal anesthesia

Purpose. Despite adequate levels of sensory blockade, patients sometimes complain of abdominal pain during cesarean section performed under spinal anesthesia. The aim of this study was to evaluate the effects of epidural fentanyl and intravenous flurbiprofen on visceral pain during cesarean section in patients having spinal anesthesia. Methods. Thirty ASA physical status I and II patients undergoing elective cesarean section were studied. Spinal-epidural anesthesia was performed in all groups. Group A received no additional analgesics, group B received epidural fentanyl 100 μg, and group C received flurbiprofen 50 mg i.v. immediately after the delivery. Postdelivery, intraoperative visceral pain was evaluated by using the visual analog scale. Incidence and visual analog scale scores of visceral pain and incidence of intraoperative nausea and vomiting were obtained from each patient. Results. Visual analog scale scores of pain were significantly lower in group B than in the other groups (P < 0.05). The incidence of nausea was comparable in all groups. The incidence of intraoperative vomiting was lower in group C than in the other groups (P < 0.05). Conclusion. Epidural fentanyl, but not intravenous flurbiprofen, decreases the incidence and severity of visceral pain during cesarean section. Received: June 16, 2000 / Accepted: December 20, 2000     

Comparison of visceral pain incidence during cesarean section performed under spinal or epidural anesthesia

The incidence of visceral pain during cesarean section performed under regional anesthesia was studied in 80 unpremedicated patients. They were divided in two similar groups concerning age, weight and height. Group 1 consisted of 40 patients submitted to cesarean section under spinal anesthesia, while in group 2 (40 patients) epidural anesthesia was used. Surgery was totally painless for all patients of group 1 patients, whereas in group 2 intraoperative analgesia was complete for 11, good in 18 and fair in 10 patients. One patient of group 2 required general anesthesia due to excrutiating pain during exteriorization of uterus despite a seemly adequate lebel of cutaneous analgesia of T₆. The authors conclude that spinal anesthesia favorably compares with epidural anesthesia for cesarean section, because the incidence of visceral pain with the former was nill and because both techniques are equally safe for mothers and neonates.(Weksler N, Ovadia L, Stav A, et al.: Comparison of visceral pain incidence during cesarean section performed under spinal or epidural anesthesia. J Anesth 6: 69–74, 1992)