Elowsson P, Norlén K
Department of Anaesthesiology and Intensive Care, Uppsala University, Sweden.
Ups J Med Sci. 2000;105(3):235-44.
Our objective was to determine the extension and duration of a stable segmental thoracic or lumbar epidural blockade by lidocaine in the 20 to 25-kg pig. Fourteen anaesthetised pigs were investigated. The radioactive isotope technetium99 (Tc99) was added to lidocaine to evaluate the spread in the epidural space. One ml of this solution was administered via an epidural catheter either at the Th(6-7) or L6-S1 level. Sensory-evoked potentials (SEPs) were measured following peripheral nerve stimulation, to determine duration and sensory extension of the epidural blockade. The thoracic anatomical mean spread was 14.2 vertebrae. The end points of the spread were C3-C7 and Th8-Th13 and the lumbar anatomical mean spread was 10.2 vertebrae. The end points were Th10-Th12 and L6-S1. It was possible to abolish the SEPs with 2 and 4% lidocaine. A smaller volume of lidocaine was needed if a second dose was administered within 20 min. With 4% lidocaine it was possible to abolish the SEPs for more than 180 min. The use of 1 ml of 4% lidocaine repeated after 20 and 60 min at the Th(6-7) or L6-S1 level achieved a stable thoracic or lumbar epidural blockade.
我们的目的是确定利多卡因在20至25千克猪中产生稳定节段性胸段或腰段硬膜外阻滞的范围和持续时间。对14头麻醉猪进行了研究。将放射性同位素锝99(Tc99)添加到利多卡因中,以评估其在硬膜外腔的扩散情况。通过硬膜外导管在胸段(6-7)或腰段L6-S1水平给予1毫升该溶液。在周围神经刺激后测量感觉诱发电位(SEP),以确定硬膜外阻滞的持续时间和感觉范围。胸段的解剖学平均扩散范围为14.2个椎体。扩散终点为C3-C7和胸段8-胸段13,腰段的解剖学平均扩散范围为10.2个椎体。终点为胸段10-胸段12和腰段L6-S1。使用2%和4%的利多卡因可以消除SEP。如果在20分钟内给予第二剂,所需的利多卡因体积较小。使用4%的利多卡因可以消除SEP超过180分钟。在胸段(6-7)或腰段L6-S1水平,在20分钟和60分钟后重复给予1毫升4%的利多卡因,可实现稳定的胸段或腰段硬膜外阻滞。