Okutomi T, Hoka S
Department of Anesthesiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Can J Anaesth. 1999 Oct;46(10):935-8. doi: 10.1007/BF03013127.
To examine the effect of modifying the interval between administration of saline used during the loss of resistance (LOR) method and local anesthetic on epidural anesthetic level and its quality.
Seventy-three patients who received thoracic epidural anesthesia were randomly allocated into three groups; the 2, 5 and 10 min groups, according to the interval between the administration of saline and 8 ml mepivacaine 1.5%. Fifteen minutes after the mepivacaine injection, the dermatome level of hypesthesia was determined by an individual blinded to the interval.
When the saline-anesthetic interval was prolonged, the hypesthetic levels for coldness and pinprick were decreased. The number of spinal segments with hypesthesia for coldness were 15 [12-20]#, 12.5 [10.5-22.5]## and 10.5 [6.5-15.5]### in the 2, 5 and 10 min groups, respectively (median [range], # P < 0.05 vs the 5 min group, ## P < 0.05 vs the 10 min group, ### P < 0.05 vs the 2 min group). The number of spinal segments with hypesthesia for pinprick were 13.5 [11-18]#, 11 [7.5-20.5]## and 10 [5.5-13]### in the 2, 5 and 10 min groups, respectively. There were differences in all groups between the number of segments with hypesthesia for coldness and pinprick elicited.
The interval between the administration of saline and local anesthetic alters the anesthetic level and quality of epidural analgesia.
探讨在阻力消失（LOR）法中使用的生理盐水与局部麻醉药给药间隔的改变对硬膜外麻醉平面及其质量的影响。
73例行胸段硬膜外麻醉的患者根据生理盐水与8 ml 1.5%甲哌卡因给药间隔随机分为三组：2分钟组、5分钟组和10分钟组。注射甲哌卡因15分钟后，由对间隔不知情的人员确定感觉减退的皮节平面。
当生理盐水-麻醉药间隔延长时，冷觉和针刺觉的感觉减退平面降低。2分钟组、5分钟组和10分钟组冷觉感觉减退的脊髓节段数分别为15[12 - 20]#、12.5[10.5 - 22.5]##和10.5[6.5 - 15.5]###（中位数[范围]，#与5分钟组相比P < 0.05，##与10分钟组相比P < 0.05，###与2分钟组相比P < 0.05）。2分钟组、5分钟组和10分钟组针刺觉感觉减退的脊髓节段数分别为13.5[11 - 18]#、11[7.5 - 20.5]##和10[5.5 - 13]###。各组冷觉和针刺觉感觉减退的节段数之间均存在差异。
生理盐水与局部麻醉药的给药间隔会改变硬膜外镇痛的麻醉平面和质量。
