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青少年中高压布比卡因的鞘内扩散

The intrathecal spread of hyperbaric dibucaine in adolescents.

作者信息

Hirabayashi Y, Shimizu R

机构信息

Department of Anesthesiology, Jichi Medical School, Tochigi-ken, Japan.

出版信息

J Anesth. 1993 Apr;7(2):167-72. doi: 10.1007/s0054030070167.

Abstract

We investigated the spread of spinal anesthesia with hyperbaric dibucaine in 20 adolescents aged 9-18 yr and 20 adults aged 23-53 yr. No significant difference was found between the two groups with regard to height, whereas a statistical significant was found between the two groups with regard to weight. Spinal anesthesia was conducted with Neo-Percamin S injected at the L3-L4 interspace through a 25-gauge spinal needle. Injected volumes of the anesthetic solution were calculated from the patients' height at 0.01 ml.cm(-1). In adolescents, 1.6 +/- 0.1 ml (mean +/- SD) of the anesthetic solution produced 19.4 +/- 1.5 spinal segments blocked. In adults, 1.6 +/- 0.1 ml of the solution produced 13.4 +/- 1.6 spinal segments blocked. A high spinal anesthesia above T5 was achieved in 17 (85%) patients in adolescents, whereas such a high level of spinal anesthesia was not experienced in adults. These results suggest that the hyperbaric dibucaine solution for spinal anesthesia in adolescents may have a tendency to produce an unexpectedly extensive spread of anesthesia.

摘要

我们研究了20名9至18岁青少年和20名23至53岁成年人中高压丁卡因脊髓麻醉的扩散情况。两组在身高方面未发现显著差异,而在体重方面两组存在统计学显著差异。通过25号脊髓穿刺针在L3-L4间隙注射新戊巴比妥进行脊髓麻醉。麻醉溶液的注射量根据患者身高以0.01 ml·cm⁻¹计算。在青少年中,1.6±0.1 ml(均值±标准差)的麻醉溶液产生19.4±1.5个脊髓节段被阻滞。在成年人中,1.6±0.1 ml的溶液产生13.4±1.6个脊髓节段被阻滞。17名(85%)青少年患者实现了T5以上的高位脊髓麻醉,而成年人未经历如此高平面的脊髓麻醉。这些结果表明,用于青少年脊髓麻醉的高压丁卡因溶液可能有产生意外广泛麻醉扩散的倾向。

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