Yokoyama K
Department of Anesthesiology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo.
Masui. 1999 Dec;48(12):1308-13.
Extent and duration of isobaric 0.5% bupivacaine spinal anesthesia by using two spinal needles; a new 25 gauge open-end pencil point spinal needle (needle tip is open as a hole after pulling out the stylet, Doctor Japan Co., Japan) and a 25 gauge Quincke needle (TOP Co., Japan) were studied clinically in 24 patients for elective lower extremity surgery. Patients were randomly assigned into two groups of 12 patients each according to the spinal needle used. Lumbar puncture was performed between L3-4 with the patient in lateral decubitus position. After isobaric 0.5% bupivacaine 4.0 ml was injected in 20 seconds, the patient was placed in supine position, and the onset of anesthesia was assessed by loss of cold sensation (alcohol sponge), sensory block (pinprick) and motor block (modified Bromage's scale) in every 5 minutes until 30 minutes. Recovery of motor block and adverse effects were assessed by a blinded observer. Sensory block at 30 minutes by Quincke needle was Th 8.4 +/- 1.0 and by new open-end pencil point needle it was Th 8.5 +/- 3.2 dermatomes. Two groups did not differ significantly in sensory block and also in motor block. No adverse effect was observed in both groups. These results indicate that this new open-end pencil point spinal needle is very useful for preventing adverse effects of spinal anesthesia.
使用两种脊髓穿刺针进行等比重0.5%布比卡因脊髓麻醉的范围和持续时间；一种新型25G开口笔尖式脊髓穿刺针（拔出针芯后针尖呈开放孔状，日本Doctor Japan公司）和一种25G Quincke针（日本TOP公司），对24例择期下肢手术患者进行了临床研究。根据所使用的脊髓穿刺针，患者被随机分为两组，每组12例。患者取侧卧位，于L3 - 4间隙行腰椎穿刺。在20秒内注入等比重0.5%布比卡因4.0 ml后，将患者置于仰卧位，每5分钟通过冷觉丧失（酒精棉球）、感觉阻滞（针刺）和运动阻滞（改良Bromage分级）评估麻醉起效情况，直至30分钟。由一名不知情的观察者评估运动阻滞的恢复情况和不良反应。Quincke针在30分钟时的感觉阻滞平面为胸8.4±1.0节段，新型开口笔尖式针为胸8.5±3.2节段。两组在感觉阻滞和运动阻滞方面均无显著差异。两组均未观察到不良反应。这些结果表明，这种新型开口笔尖式脊髓穿刺针对于预防脊髓麻醉的不良反应非常有用。
