Schiffer E, Van Gessel E, Gamulin Z
Department of Anaesthesiology, University Hospital of Geneva, Switzerland.
Br J Anaesth. 1999 Dec;83(6):943-4. doi: 10.1093/bja/83.6.943.
The extent of sensory block during spinal anaesthesia is unpredictable and is influenced by many factors, mainly patient position, site of injection, baricity and the dose of drug injected. Among other factors, cerebrospinal fluid (CSF) density has been advocated to affect subarachnoid distribution of local anaesthetics. In this study, we have investigated the influence of patient characteristics such as sex, age, weight and height on variations in the density of CSF in more than 46 consecutive patients undergoing spinal anaesthesia. CSF 2 ml was obtained after spinal puncture and before injection of local anaesthetic. Mean CSF density measured at 37 degrees C was mean 1.00054 (SD 0.00017) g ml-1, with significantly lower CSF densities in women (1.00049 (0.00011) g ml-1) than in men (1.00058 (0.00011) g ml-1) (P = 0.024). In contrast, there was no correlation between age, weight or height, and CSF density. These results suggest that sex significantly influenced CSF density and may therefore modify subarachnoid distribution of local anaesthetics.
脊髓麻醉期间感觉阻滞的范围不可预测，且受多种因素影响，主要包括患者体位、注射部位、比重和注射药物剂量。在其他因素中，有人主张脑脊液（CSF）密度会影响局部麻醉药在蛛网膜下腔的分布。在本研究中，我们调查了46例以上连续接受脊髓麻醉患者的性别、年龄、体重和身高这些患者特征对脑脊液密度变化的影响。在脊髓穿刺后且注射局部麻醉药前获取2 ml脑脊液。在37℃测量的脑脊液平均密度为1.00054（标准差0.00017）g/ml，女性的脑脊液密度（1.00049（0.00011）g/ml）显著低于男性（1.00058（0.00011）g/ml）（P = 0.024）。相比之下，年龄、体重或身高与脑脊液密度之间无相关性。这些结果表明，性别显著影响脑脊液密度，因此可能会改变局部麻醉药在蛛网膜下腔的分布。
