Casati Andrea, Chelly Jacques E, Cerchierini Elisa, Santorsola Roberta, Nobili Fiorella, Grispigni Crispino, Di Benedetto Pia, Torri Giorgio
Vita-Salute University, Department of Anesthesiology, IRCCS H. San Raffaele, Milan, Italy.
J Clin Anesth. 2002 Mar;14(2):111-4. doi: 10.1016/s0952-8180(01)00364-6.
To compare the intraoperative and postoperative clinical properties of the sciatic nerve block performed with either 0.5% bupivacaine or 0.5% levobupivacaine for orthopedic foot procedures.
Randomized, double-blind study.
Inpatient unit of a university-affiliated hospital.
30 ASA physical status I and II patients undergoing elective hallux valgus repair under regional anesthesia.
After administering intravenous (IV) midazolam premedication (0.05 mg/kg), a femoral nerve block was performed with 15 mL of mepivacaine 2%. Patients were then randomly allocated to receive, in a double-blind fashion, a sciatic nerve block with 20 mL of either 0.5% bupivacaine (n = 15) or 0.5% levobupivacaine (n = 15).
An observer who was blinded to the study drug recorded the onset time, quality, and duration of the sciatic nerve block. Postoperative analgesia consisted of 100 mg IV ketoprofen every 8 hours, with the first administration given at the patient's request. Mean (+/-SEM) onset time of the sciatic nerve block was 35 +/- 5 minutes for bupivacaine and 31 +/- 6 minutes for levobupivacaine (p = not significant [NS]). The duration of motor and sensory blocks with bupivacaine was 761 +/- 112 minutes and 790 +/- 110 minutes, respectively, and 716 +/- 80 minutes and 814 +/- 73 minutes, respectively, with levobupivacaine (p = NS). The first pain medication was requested after 844 +/- 96 minutes with bupivacaine and 872 +/- 75 minutes after levobupivacaine (p = NS). No differences in the quality of nerve block and patient satisfaction were reported between the two groups.
A dose of 20 mL of 0.5% levobupivacaine induces sciatic nerve block of similar onset, duration, and intensity as the block produced by the same volume and concentration of the racemic solution of bupivacaine.
比较在足部骨科手术中，使用0.5%布比卡因或0.5%左旋布比卡因进行坐骨神经阻滞的术中和术后临床特性。
随机双盲研究。
大学附属医院住院部。
30例美国麻醉医师协会（ASA）身体状况为I级和II级、接受区域麻醉下择期拇外翻修复术的患者。
静脉注射咪达唑仑进行术前用药（0.05 mg/kg）后，用15 mL 2%甲哌卡因进行股神经阻滞。然后将患者随机分为两组，以双盲方式分别接受20 mL 0.5%布比卡因（n = 15）或0.5%左旋布比卡因（n = 15）的坐骨神经阻滞。
一名对研究用药不知情的观察者记录坐骨神经阻滞的起效时间、质量和持续时间。术后镇痛为每8小时静脉注射100 mg酮洛芬，首次给药根据患者需求进行。布比卡因组坐骨神经阻滞的平均（±标准误）起效时间为35 ± 5分钟，左旋布比卡因组为31 ± 6分钟（p = 无显著差异[NS]）。布比卡因组运动和感觉阻滞的持续时间分别为761 ± 112分钟和790 ± 110分钟，左旋布比卡因组分别为716 ± 80分钟和814 ± 73分钟（p = NS）。布比卡因组在844 ± 96分钟后首次要求使用止痛药物，左旋布比卡因组在872 ± 75分钟后首次要求使用止痛药物（p = NS）。两组之间在神经阻滞质量和患者满意度方面未报告有差异。
20 mL 0.5%左旋布比卡因诱导的坐骨神经阻滞在起效时间、持续时间和强度方面与相同体积和浓度的布比卡因消旋液所产生的阻滞相似。
