Stienstra R, Van Poorten F
Department of Anesthesiology, Reinier de Graaf Gasthuis, The Netherlands.
Reg Anesth. 1990 Jul-Aug;15(4):208-10.
Three milliliters of plain bupivacaine 0.5%, previously warmed to 37 degrees C, was injected into the subarachnoid space in two groups of 20 patients. In Group 1, speed of injection of the bupivacaine solution was as fast as possible (mean, 0.54 ml/second), whereas in Group 2 the bupivacaine solution was administered at a rate of 0.05 ml/second. Patients were kept sitting for 3 minutes after completion of the subarachnoid injection. All observations were made by an observer unaware of the speed of injection. There were no statistically significant differences in onset to maximal level of sensory block (17.2 minutes in Group 1 versus 19 minutes in Group 2) or complete motor block of the lower limbs (9 minutes in both groups). The difference in the maximal level of sensory block as determined by pinprick (T4.9 in Group 1 versus T3.4 in Group 2) was statistically significant; this difference may be explained by the fact that the plain solution of bupivacaine 0.5% at 37 degrees C is hypobaric and patients in Group 2 were in the sitting position for 1 minute longer when measured from the start of the subarachnoid injection. It is concluded that a tenfold difference in speed of injection does not significantly affect subarachnoid spread or onset of sensory and motor block with 0.5% bupivacaine.
将3毫升预先加热至37摄氏度的0.5%布比卡因原液注入两组各20例患者的蛛网膜下腔。在第1组中，布比卡因溶液的注射速度尽可能快（平均0.54毫升/秒），而在第2组中，布比卡因溶液以0.05毫升/秒的速度给药。蛛网膜下腔注射完成后，患者保持坐姿3分钟。所有观察均由一名不知道注射速度的观察者进行。感觉阻滞达到最大水平的起效时间（第1组为17.2分钟，第2组为19分钟）或下肢完全运动阻滞（两组均为9分钟）无统计学显著差异。通过针刺确定的感觉阻滞最大水平的差异具有统计学意义（第1组为T4.9，第2组为T3.4）；这种差异可能是由于37摄氏度的0.5%布比卡因原液为低比重液，且从蛛网膜下腔注射开始测量时，第2组患者的坐姿保持时间长1分钟。得出的结论是，注射速度相差10倍对0.5%布比卡因的蛛网膜下腔扩散或感觉及运动阻滞的起效没有显著影响。
