Swann D G, Armstrong P J, Douglas E, Brockway M, Bowler G M
Department of Anaesthetics, Royal Infirmary Edinburgh.
Anaesthesia. 1991 Mar;46(3):174-6. doi: 10.1111/j.1365-2044.1991.tb09402.x.
A double-blind randomised study was performed to investigate the effect of pH adjustment of bupivacaine, with adrenaline 1:200,000, on the duration of block and pain relief after intercostal nerve blockade following thoracotomy. One group (n = 10) received bupivacaine with adrenaline 1:200,000 (pH = 4.1) and the other (n = 10) received alkalinised bupivacaine with adrenaline 1:200,000 (pH = 6.9). There was no significant difference in block duration (mean 23.9 and 26.4 hours respectively) visual analogue pain scores or morphine usage. Patients were more likely to have a block during the first 12 hours if they received alkalinised bupivacaine (p less than 0.01, Chi-squared test). A progressive regression of block, not previously described, was observed, explicable by means of spread of local anaesthesia to adjacent intercostal nerves. Alkalinisation of bupivacaine with adrenaline for intercostal nerve blockade has little clinical benefit.
进行了一项双盲随机研究，以调查布比卡因（含1:200,000肾上腺素）pH值调整对开胸术后肋间神经阻滞后阻滞持续时间和疼痛缓解的影响。一组（n = 10）接受含1:200,000肾上腺素的布比卡因（pH = 4.1），另一组（n = 10）接受碱化的含1:200,000肾上腺素的布比卡因（pH = 6.9）。两组在阻滞持续时间（分别为平均23.9小时和26.4小时）、视觉模拟疼痛评分或吗啡用量方面无显著差异。接受碱化布比卡因的患者在最初12小时内更有可能出现阻滞（p小于0.01，卡方检验）。观察到一种此前未描述的阻滞逐渐消退情况，这可以通过局部麻醉药向相邻肋间神经扩散来解释。碱化含肾上腺素的布比卡因用于肋间神经阻滞临床益处不大。
