Contreras-Domínguez V, Carbonell-Bellolio P, Sanzana Salamanca E, Ojeda-Grecie A
Servicio de Anestesiología, Hospital Clínico Regional de Concepción, Facultad de Medicina, Universidad de Concepción, Chile.
Rev Esp Anestesiol Reanim. 2006 Nov;53(9):532-7.
The axillary brachial plexus block is a frequently performed anesthetic technique. Adding a variety of coadjuvant drugs has been shown to improve results. This study evaluated the addition of sodium bicarbonate (NaHCO3) and/or clonidine to mepivacaine for performing the block.
Sixty patients between 18 and 70 years old, ASA 1-3 in stable condition received axillary brachial plexus blocks in a randomized controlled study. Four groups of 15 patients each were formed: group I (control group) received 40 mL of 1% mepivacaine with adrenaline plus 5 mL of saline; group II, 40 mL of 1% mepivacaine with adrenaline plus 4 mL of NaHCO3 and 1 mL of saline; group III, 40 mL of 1% mepivacaine with 150 microg of clonidine plus 4mL of saline; and group IV, 40 mL of 1% mepivacaine with adrenaline plus 4 mL of NaHCO3 and 150 microg of clonidine.
The onset time was significantly shorter in groups 2 and 4. The duration of the block was longer in group 3 and the analgesic effect was significantly better.
Adding NaHCO3 to mepivacaine shortens the time of onset of an axillary brachial plexus block. Including clonidine prolongs the duration of anesthesia and analgesia. The addition of both NaHCO3 and clonidine shortens time to onset but does not prolong duration of anesthesia or analgesia.
腋路臂丛神经阻滞是一种常用的麻醉技术。已证明添加多种辅助药物可改善效果。本研究评估了在甲哌卡因中添加碳酸氢钠（NaHCO₃）和/或可乐定用于实施该阻滞的情况。
在一项随机对照研究中，60例年龄在18至70岁之间、ASA 1 - 3级且病情稳定的患者接受腋路臂丛神经阻滞。每组15例患者，共分为四组：第一组（对照组）接受40 mL含肾上腺素的1%甲哌卡因加5 mL生理盐水；第二组，40 mL含肾上腺素的1%甲哌卡因加4 mL NaHCO₃和1 mL生理盐水；第三组，40 mL含150微克可乐定的1%甲哌卡因加4 mL生理盐水；第四组，40 mL含肾上腺素的1%甲哌卡因加4 mL NaHCO₃和150微克可乐定。
第二组和第四组的起效时间明显更短。第三组的阻滞持续时间更长，镇痛效果明显更好。
在甲哌卡因中添加NaHCO₃可缩短腋路臂丛神经阻滞的起效时间。加入可乐定可延长麻醉和镇痛的持续时间。同时添加NaHCO₃和可乐定可缩短起效时间，但不会延长麻醉或镇痛的持续时间。
