Wong Cynthia A, Cariaso Dominador, Johnson Eric C, Leu Diana, McCarthy Robert J
Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
Can J Anaesth. 2003 Aug-Sep;50(7):689-93. doi: 10.1007/BF03018711.
To determine if the extent of sensory blockade after the intrathecal injection of hypobaric fentanyl (25 micro g) and bupicavaine (2.5 mg) in the sitting position in term parturients is influenced by body habitus.
A prospective observational study in 245 term parturients who received intrathecal fentanyl and bupivacaine plus an epidural test dose to initiate labour analgesia at an academic university hospital. The highest sensory blockade to ice and pinprick was determined at 15 and 30 min after the intrathecal injection. Correlations between sensory blockade and parturient height, weight and body mass index (BMI) were determined.
There was no association between highest sensory blockade and parturients' height. Increasing weight and BMI were associated with increased cephalad sensory blockade at 15 min, but not at 30 min. The estimated difference in sensory level between women at the extremes of BMI, based on our linear regression model, was less than one dermatome.
Height did not influence the extent of sensory analgesia after initiation of intrathecal labour analgesia using a hypobaric solution injected with the parturient in the sitting position. Weight and BMI were associated with a non-clinically significant increase in the cephalic spread of analgesia, suggesting that dose adjustments based on body habitus in this population are not necessary.
确定足月产妇在坐位下鞘内注射低比重芬太尼（25微克）和布比卡因（2.5毫克）后感觉阻滞的范围是否受身体形态的影响。
在一所大学附属医院对245名接受鞘内注射芬太尼和布比卡因加硬膜外试验剂量以启动分娩镇痛的足月产妇进行前瞻性观察研究。在鞘内注射后15分钟和30分钟测定对冰敷和针刺的最高感觉阻滞。确定感觉阻滞与产妇身高、体重和体重指数（BMI）之间的相关性。
最高感觉阻滞与产妇身高之间无关联。体重和BMI增加与15分钟时头端感觉阻滞增加有关，但30分钟时无关。根据我们的线性回归模型，BMI极端值女性之间感觉平面的估计差异小于一个皮节。
身高不影响在坐位下向产妇注射低比重溶液启动鞘内分娩镇痛后的感觉镇痛范围。体重和BMI与镇痛头端扩散的非临床显著增加有关，表明在该人群中基于身体形态进行剂量调整没有必要。
