两种不同剂量的0.75%无糖罗哌卡因用于脊髓麻醉：中国剖宫产产妇的疗效与安全性比较

Spinal anesthesia with two different dosages of 0.75% glucose-free ropivacaine: a comparison of efficacy and safety in Chinese parturients undergoing cesarean section.

作者信息

Wong John On-Nin, Tan Thomas Dou-Moo, Leung Pak-On, Tseng Kin-Fui, Cheu Ning-Wei

机构信息

Department of Anesthesiology, Pain Management, Critical Care Medicine and Palliative Medicine, St. Martin De Porres Hospital, 565, Da-Ya Road, Sec. 2, Chia-yi City 600, Taiwan, R.O.C.

出版信息

Acta Anaesthesiol Sin. 2003 Sep;41(3):131-8.

PMID:14601199

Abstract

BACKGROUND

We compared the clinical efficacy and safety between 2 doses of 2.5 ml (18.75 mg) and 3 ml (22.5 mg) of 0.75% glucose free spinal ropivacaine in Chinese parturients undergoing Cesarean section.

METHODS

In this randomized, open-label study, 40 parturients enrolled were divided into two groups: Group A received a 2.5 ml 0.75% ropivacaine as opposed to 3 ml in Group B. Sensory and motor blocks were assessed during and after surgery until complete recovery. Eight standard measurements were taken: time at onset of sensory block; maximum cephalic sensory spread; maximum number of blocked segments; time to maximum sensory block; duration of sensory block at L3; time at onset of complete motor block and duration until complete recovery. Vital signs and any adverse effects related to spinal anesthesia were also recorded.

RESULTS

Five of the 6 variables showed no significant difference between groups A and B: onset time of sensory block at L3 was 1.8 +/- 6.7 min vs. 2.3 +/- 9.8 min; maximum cephalic spread was T3-4 (C3-T7) vs. T3 (C2-T8); maximum number of blocked segments was 20.7 +/- 3.5 vs. 20.2 +/- 3.4; time to maximum sensory block 15.4 +/- 5.5 min vs. 20.3 +/- 15.1 min; time for regression to L3 was 200.8 +/- 59.5 min vs. 215.0 +/- 37.6 min and time for complete recovery of motor block 208.5 +/- 55.5 min vs. 226.5 +/- 461. min. Group B had a significantly faster onset time for complete motor block (P < 0.05) 15.4 +/- 5.6 min vs. 10.4 +/- 4.7 min. Moreover, there were no significant differences in global hemodynamic changes during and after the operation. Transient hypotension attacks were more frequent in group A at the beginning of anesthesia, perhaps due to inadequate prehydration. Otherwise, there were no differences in adverse effects during or after surgery.

CONCLUSIONS

We conclude that for Cesarean section in Chinese parturients either 18.75 mg (2.5 ml) or 22.5 mg (3 ml) 0.75% glucose-free ropivacaine can provide a spinal anesthesia of the same efficacy and safety.

摘要

背景

我们比较了2.5毫升（18.75毫克）和3毫升（22.5毫克）两种剂量的0.75%无糖罗哌卡因用于中国剖宫产产妇脊髓麻醉时的临床疗效和安全性。

方法

在这项随机、开放标签研究中，40名入选产妇被分为两组：A组接受2.5毫升0.75%罗哌卡因，B组接受3毫升。在手术期间及术后直至完全恢复，对感觉和运动阻滞进行评估。进行了八项标准测量：感觉阻滞起效时间；最大头端感觉平面；最大阻滞节段数；达到最大感觉阻滞的时间；L3水平感觉阻滞持续时间；完全运动阻滞起效时间及直至完全恢复的持续时间。还记录了生命体征以及与脊髓麻醉相关的任何不良反应。

结果

六个变量中的五个在A组和B组之间无显著差异：L3水平感觉阻滞起效时间分别为1.8±6.7分钟和2.3±9.8分钟；最大头端平面为T3 - 4（C3 - T7）和T3（C2 - T8）；最大阻滞节段数分别为20.7±3.5和20.2±3.4；达到最大感觉阻滞的时间分别为15.4±5.5分钟和20.3±15.1分钟；恢复到L3水平的时间分别为200.8±59.5分钟和215.0±37.6分钟；运动阻滞完全恢复的时间分别为208.5±55.5分钟和226.5±46.1分钟。B组完全运动阻滞的起效时间显著更快（P<0.05），分别为15.4±5.6分钟和10.4±4.7分钟。此外，手术期间及术后整体血流动力学变化无显著差异。麻醉开始时A组短暂性低血压发作更频繁，可能是由于预补液不足。除此之外，手术期间及术后不良反应无差异。