Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, Iksan, Korea.
Korean J Pain. 2010 Sep;23(3):186-9. doi: 10.3344/kjp.2010.23.3.186. Epub 2010 Aug 26.
Circadian variations in the absorption, distribution, protein binding, elimination and metabolism of drugs account for many of the administration-time-dependent differences in their pharmacokinetics. The aim of this study is to determine whether the time of intrathecal injection influences spinal anesthesia.
Ninety patients scheduled for orthopedic surgery were randomly assigned to three groups. Each group received spinal anesthesia with 0.5% bupivacaine 10 mg at different times; group AM (8 am to 12:00), group Noon (12:00 to 4:00 pm) and group PM (4:00 pm to 8:00 pm). Sensory and motor blockade were assessed by pinprick and a four-point modified Bromage scale. Time to first postoperative analgesic requirement and side effects such as hypotension, bradycardia, nausea, and shivering were recorded.
No significant differences were found among the three groups in peak sensory blockade, duration of motor block to Bromage 1 or side effects, but time to first postoperative analgesic requirement (P = 0.008), and recovery time of S1 sensation to pinprick were significantly prolonged in group Noon compared with the other groups (P = 0.03).
The tine of administration of spinal local anesthetics influences the duration of local anesthesia.
药物的吸收、分布、蛋白结合、消除和代谢的昼夜变化导致其药代动力学的许多给药时间依赖性差异。本研究旨在确定鞘内注射时间是否会影响脊髓麻醉。
90 例行骨科手术的患者被随机分为三组。每组均在不同时间接受 0.5%布比卡因 10mg 的脊髓麻醉；上午组（8:00 至 12:00）、中午组（12:00 至 16:00）和下午组（16:00 至 20:00）。采用针刺法和改良 Bromage 四点量表评估感觉和运动阻滞。记录首次术后镇痛需求时间以及低血压、心动过缓、恶心和寒战等不良反应。
三组之间在感觉阻滞峰值、运动阻滞至 Bromage 1 的持续时间或不良反应方面无显著差异，但中午组首次术后镇痛需求时间（P=0.008）和针刺感觉 S1 恢复时间明显长于其他两组（P=0.03）。
局部麻醉药物的给药时间会影响局部麻醉的持续时间。
