Iino O, Omi S, Yokoyama K
Department of Anesthesiology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo 206-8512.
Masui. 2001 Jul;50(7):762-5.
The spread and time to two-segment regression of spinal anesthesia with 0.25% hyperbaric bupivacaine 2.0 ml (5 mg) were studied clinically in 20 patients for elective lower extremity, urological or gynecological surgery. Lumbar puncture was performed at the L 3-4 interspace with the patient in horizontal lateral decubitus positions using a 25-G Quincke needle. After injection of the local anesthetic solution at the rate of 0.2 ml.sec-1, the patient was placed immediately in supine position. Sensory block was assessed by using pinprick and motor block was assessed by using a four-point Bromage scale in every 5 min until 30 min, then every 10 min thereafter until two-segment regression of sensory block had recovered. Results were expressed as mean values +/- SD. Maximum sensory block level was Th 10.6 +/- 2.3, and time to two-segment regression was 51.5 +/- 14.6 min. Complete motor block was observed in three out of twenty patients (15%). These results indicate that spinal anesthesia with 0.25% hyperbaric bupivacaine is useful for a short case, which dose not require motor block or is performed as day-care surgery.
对20例择期行下肢、泌尿外科或妇科手术的患者进行了临床研究,观察了2.0 ml(5 mg)0.25%重比重布比卡因脊麻的扩散情况及达到双节段消退的时间。患者取侧卧位,在L 3-4椎间隙用25G Quincke针行腰椎穿刺。以0.2 ml·sec-1的速度注射局部麻醉药溶液后,患者立即改为仰卧位。每5分钟用针刺法评估感觉阻滞,用四点Bromage评分法评估运动阻滞,直至30分钟,此后每10分钟评估一次,直至感觉阻滞恢复双节段消退。结果以平均值±标准差表示。最大感觉阻滞平面为胸10.6±2.3,达到双节段消退的时间为51.5±14.6分钟。20例患者中有3例(15%)出现完全运动阻滞。这些结果表明,0.25%重比重布比卡因脊麻适用于不需要运动阻滞或作为日间手术的短时间手术。