0.5% S(-)-布比卡因用于择期下肢手术的脊髓麻醉。

Spinal anesthesia with 0.5% S(-)-bupivacaine for elective lower limb surgery.

作者信息

Burke D, Kennedy S, Bannister J

机构信息

Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, Scotland.

出版信息

Reg Anesth Pain Med. 1999 Nov-Dec;24(6):519-23. doi: 10.1016/s1098-7339(99)90042-1.

DOI:10.1016/s1098-7339(99)90042-1

PMID:10588555

Abstract

BACKGROUND AND OBJECTIVES

This study examines the clinical effects of the subarachnoid administration of levobupivacaine, the S(-)-enantiomer of racemic bupivacaine.

METHODS

An open, noncomparative study was performed on 20 patients undergoing elective lower limb surgery. Three milliliters of a plain solution of 0.5% S(-)-bupivacaine ( 15 mg) was administered via the L2 or L3 interspace with the patient in the sitting position. Following injection, the patients were immediately placed supine. Spread of sensory analgesia, degree of motor block, and hemodynamic parameters were recorded.

RESULTS

Satisfactory surgical anesthesia was achieved in 18 patients. The median time to onset of analgesia was 2 minutes (ranging 2-10 minutes) and the median duration of analgesia was 388 minutes (range, 295-478 minutes). This group of patients achieved complete motor block, with a median onset time of 5 minutes (2-10 minutes) and duration of 266 minutes (range, 170-415 minutes). Sensory block height was inadequate for surgery in 2 patients, who received supplemental anesthesia.

CONCLUSIONS

The results suggest that S(-)-bupivacaine can provide satisfactory surgical anesthesia, but the spread of the plain solution is unpredictable.

摘要

背景与目的

本研究探讨了左旋布比卡因（消旋布比卡因的S(-)-对映体）蛛网膜下腔给药的临床效果。

方法

对20例行择期下肢手术的患者进行了一项开放性、非对照研究。患者取坐位，通过L2或L3椎间隙给予3毫升0.5% S(-)-布比卡因（15毫克）的纯溶液。注射后，患者立即改为仰卧位。记录感觉镇痛的范围、运动阻滞程度和血流动力学参数。

结果

18例患者获得了满意的手术麻醉效果。镇痛起效的中位时间为2分钟（范围2 - 10分钟），镇痛的中位持续时间为388分钟（范围295 - 478分钟）。该组患者均达到了完全运动阻滞，运动阻滞起效的中位时间为5分钟（2 - 10分钟），持续时间为266分钟（范围170 - 415分钟）。2例患者的感觉阻滞平面不足以进行手术，接受了辅助麻醉。