Kumar A, Bala I, Bhukal I, Singh H
Department of Anaesthesiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Can J Anaesth. 1992 Nov;39(9):915-9. doi: 10.1007/BF03008339.
Spinal anaesthesia with 2, 2.5 or 3 ml of glucose-free lidocaine 2% was studied in 50 patients undergoing Caesarean section. Onset time, cephalad spread of analgesia, quality of analgesia, muscle relaxation, the cardiovascular effects and duration of analgesia and motor block were assessed. Reliable anaesthesia was provided with 2.5 and 3 ml while 2 ml of 2% lidocaine was insufficient. Onset time varied between 5.5 to 6 min and maximum cephalad spread was achieved in 10-15 min. The mean maximum extent of sensory analgesia was higher after 2.5 ml (T4.1) and 3 ml (T3.6) than after 2 ml (T7) (P < 0.001). Complete motor block was achieved in all the patients. The mean duration of sensory block was 123 +/- 6.23 min (2 ml) to 126 +/- 7.53 min (2.5 and 3 ml). The mean duration of motor block in 2.5 and 3 ml groups was higher (P < 0.001) than in the 2 ml group and was correlated with the dose of lidocaine (P < 0.05). Hypotension (SBP < 100 mmHg) was noted in 10% (n = 5) of patients in whom the cephalad spread of analgesia was also higher. All the neonates had an apgar score of 7 or more at 1 min. These results suggest that 2.5 to 3 ml of 2% lidocaine provides satisfactory anaesthesia for Caesarean section.
对50例接受剖宫产手术的患者，研究了使用2毫升、2.5毫升或3毫升不含葡萄糖的2%利多卡因进行脊髓麻醉的情况。评估了起效时间、镇痛向头端的扩散、镇痛质量、肌肉松弛情况、心血管效应以及镇痛和运动阻滞的持续时间。2.5毫升和3毫升利多卡因可提供可靠的麻醉效果，而2毫升2%利多卡因则不足。起效时间在5.5至6分钟之间，10至15分钟时达到最大头端扩散。2.5毫升（T4.1）和3毫升（T3.6）利多卡因组的平均最大感觉镇痛范围高于2毫升（T7）组（P<0.001）。所有患者均实现了完全运动阻滞。感觉阻滞的平均持续时间为123±6.23分钟（2毫升组）至126±7.53分钟（2.5毫升和3毫升组）。2.5毫升和3毫升组的平均运动阻滞持续时间高于2毫升组（P<0.001），且与利多卡因剂量相关（P<0.05）。10%（n=5）的患者出现低血压（收缩压<100 mmHg），这些患者的镇痛向头端扩散也较高。所有新生儿在1分钟时的阿氏评分均为7分或更高。这些结果表明，2.5至3毫升2%利多卡因可为剖宫产手术提供满意的麻醉效果。
