Hauch M A, Hartwell B L, Hunt C O, Datta S
Department of Anesthesia, Brigham and Women's Hospital, Boston, MA 02115.
Reg Anesth. 1990 Mar-Apr;15(2):81-5.
Hyperbaric solutions of 0.75% bupivacaine (8.25% dextrose), and 1% tetracaine mixed with an equal volume of 10% procaine were compared in a double-blind study of 22 parturients undergoing elective cesarean delivery and spinal anesthesia. The onset of sensory anesthesia and motor block was similar in the two groups. The maximal level of sensory anesthesia to pinprick was significantly higher after the use of the tetracaine-procaine mixture. The adequacy of anesthesia was similar in both groups as indicated by the lack of differences with regard to anesthetic supplementation between the groups. However, a significantly shorter duration of sensory anesthesia and motor blockade occurred in the group in which bupivacaine was employed. The incidence of hypotension was higher in those patients receiving the tetracaine-procaine mixture as indicated by the use of significantly higher total doses of ephedrine to maintain baseline blood pressure in this group. No differences in Apgar scores or blood gases were noted between the two groups of patients. This study suggests that hyperbaric 0.75% bupivacaine offers certain advantages over hyperbaric tetracaine-procaine when used in equal volumes for spinal anesthesia cesarean delivery.
在一项针对22例行择期剖宫产和脊髓麻醉的产妇的双盲研究中，对0.75%布比卡因（8.25%葡萄糖）的高压溶液以及1%丁卡因与等量10%普鲁卡因混合液进行了比较。两组的感觉麻醉和运动阻滞起效情况相似。使用丁卡因 - 普鲁卡因混合液后，对针刺的最大感觉麻醉平面显著更高。两组间麻醉补充情况无差异，表明两组麻醉效果相当。然而，使用布比卡因的组感觉麻醉和运动阻滞持续时间明显更短。接受丁卡因 - 普鲁卡因混合液的患者低血压发生率更高，该组维持基线血压所需麻黄碱总剂量显著更高即表明了这一点。两组患者的阿氏评分或血气指标均无差异。本研究表明，在等量用于剖宫产脊髓麻醉时，0.75%高压布比卡因比高压丁卡因 - 普鲁卡因具有某些优势。
