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可乐定延长布比卡因腰麻的作用时间

[Prolongation of hyperbaric bupivacaine spinal anesthesia with clonidine].

作者信息

Seah Y S, Chen C, Chung K D, Wong C H, Tan P P

机构信息

Department of Anesthesiology, Chang-Gung Memorial Hospital, Taipei, Taiwan, R.O.C.

出版信息

Ma Zui Xue Za Zhi. 1991 Mar;29(1):533-7.

PMID:1758244
Abstract

Recent reports showed that spinal clonidine might provide satisfactory analgesia via a nonopioid mechanism. In this study we tried to evaluate the prolongation of analgesic effect of the hyperbaric bupivacaine spinal anesthesia with clonidine. 40 ASA class I-II patients scheduled for TURP were randomly classified into two groups of 20 each. In saline group, 3 ml 0.5% hyperbaric bupivacaine plus 1 ml normal saline was given. In clonidine group, 1 ml (0.15 mg) clonidine in addition to 3 ml 0.5% bupivacaine was given. All the patients were placed in lateral position and dural puncture was made at the L3-4 interspace using a 25G spinal needle. Assessment of the sensory blockade by "pinprick" and motor blockade by Bromage scale and measurement of blood pressure and heart rate were performed after injection. All data were analyzed by Student's t-test. A p value less than 0.05 was considered statistically significant. Our results showed that the highest sensory blockade level and the time required for maximal spread of the sensory blockade were of no significant difference between groups. The mean time for two segments regression and mean time for regression to L2 were significantly greater in the clonidine group than in the saline group (p less than 0.001). Motor blockade was also prolonged in the clonidine group than the clonidine group. Side effects such as hypotension (10 in clonidine gp vs 4 in saline gp) and bradycardia (4 clonidine gp vs 2 in saline gp) commonly occurred in the clonidine group, but all patients could be effectively treated with ephedrine and atropine respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

近期报告显示,脊髓可乐定可能通过非阿片类机制提供满意的镇痛效果。在本研究中,我们试图评估可乐定对布比卡因重比重腰麻镇痛效果的延长作用。40例拟行经尿道前列腺切除术(TURP)的ASA I-II级患者被随机分为两组,每组20例。生理盐水组给予3ml 0.5%重比重布比卡因加1ml生理盐水。可乐定组除给予3ml 0.5%布比卡因外,还给予1ml(0.15mg)可乐定。所有患者均取侧卧位,使用25G腰穿针于L3-4间隙进行硬膜穿刺。注射后采用“针刺”评估感觉阻滞,采用Bromage评分评估运动阻滞,并测量血压和心率。所有数据采用Student's t检验进行分析。p值小于0.05被认为具有统计学意义。我们的结果显示,两组之间最高感觉阻滞平面及感觉阻滞最大扩散所需时间无显著差异。可乐定组感觉阻滞平面下降两个节段的平均时间及恢复至L2的平均时间均显著长于生理盐水组(p<0.001)。可乐定组运动阻滞也较生理盐水组延长。可乐定组常见低血压(可乐定组10例,生理盐水组4例)和心动过缓(可乐定组4例,生理盐水组2例)等副作用,但所有患者分别用麻黄碱和阿托品均可有效治疗。(摘要截选至250字)

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