Girgin N K, Gurbet A, Turker G, Bulut T, Demir S, Kilic N, Cinar A
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Uludag University, Bursa, Turkey.
J Int Med Res. 2008 Nov-Dec;36(6):1287-92. doi: 10.1177/147323000803600616.
This study investigated whether the addition of 25 microg intrathecal fentanyl to levobupivacaine spinal anaesthesia for outpatient inguinal herniorrhaphy allows a sub-anaesthetic levobupivacaine dose to be used. Forty patients were assigned to receive 5 mg levobupivacaine 0.5% mixed with 25 microg fentanyl (group LF) or 7.5 mg levobupivacaine 0.5% (group L). The highest sensory block levels achieved were T7 (range T5 - T9) and T6 (range T4 - T9) in groups LF and L, respectively. The times to two-segment regression, S2 regression, ambulation, urination and discharge were all significantly shorter in group LF than group L. These results indicate that, for outpatient inguinal herniorrhaphy, intrathecal fentanyl combined with low-dose levobupivacaine provides good quality spinal anaesthesia and minimizes the need for intra-operative analgesia. This protocol is well suited for the outpatient setting because it features rapid recovery of full motor power, sensory function and bladder function.
本研究调查了门诊腹股沟疝修补术患者在左旋布比卡因腰麻中添加25微克鞘内注射芬太尼是否能使左旋布比卡因剂量低于麻醉剂量。40例患者被分配接受5毫克0.5%左旋布比卡因与25微克芬太尼混合液（LF组）或7.5毫克0.5%左旋布比卡因（L组）。LF组和L组分别达到的最高感觉阻滞平面为T7（范围T5 - T9）和T6（范围T4 - T9）。LF组两段回归、S2回归、行走、排尿和出院时间均显著短于L组。这些结果表明，对于门诊腹股沟疝修补术，鞘内注射芬太尼联合低剂量左旋布比卡因可提供高质量的腰麻，并将术中镇痛需求降至最低。该方案非常适合门诊环境，因为其特点是运动功能、感觉功能和膀胱功能能快速恢复。
