Gaiser Robert R
Department of Anesthesiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
J Clin Anesth. 2003 Sep;15(6):474-7. doi: 10.1016/s0952-8180(03)00113-2.
Many anesthesiologists have called for the abandonment of the epidural test dose in the obstetric patient, citing its lack of sensitivity and specificity. A test dose of lidocaine 1.5% with epinephrine 1:200,000, in combination with aspiration, is highly effective in detecting incorrect placement of an epidural catheter. If the catheter is intrathecal, it requires approximately 2 minutes to obtain a sensory level. For the detection of an intravascular catheter, a positive test dose would result in a sudden increase in the maternal heart rate of 10 beats per minute within 1 minute after injection. It should not be administered during uterine contraction, as labor pain may trigger a tachycardic response. This test dose has been extensively studied and is safe both for both mother and fetus.
许多麻醉医生呼吁放弃在产科患者中使用硬膜外试验剂量，理由是其缺乏敏感性和特异性。1.5%利多卡因与1:200,000肾上腺素的试验剂量，结合回抽，在检测硬膜外导管误置方面非常有效。如果导管误入蛛网膜下腔，大约需要2分钟才能获得感觉平面。为检测血管内导管，阳性试验剂量会导致注射后1分钟内产妇心率突然增加10次/分钟。不应在子宫收缩时给药，因为分娩疼痛可能引发心动过速反应。这种试验剂量已得到广泛研究，对母亲和胎儿都是安全的。
