Akhtar M Nauman, Tariq Sabahat, Abbas Nighat, Murtaza Ghulam, Nadeem Naqvi S M
Department of Anaesthesia and Critical Care, Liaquat National Hospital, Karachi.
J Coll Physicians Surg Pak. 2012 Dec;22(12):747-50.
To assess the haemodynamic changes in patients receiving unilateral and bilateral spinal anaesthesia with their pre-anaesthesia recordings.
Quasi-experimental study.
Main Operation Theater, Liaquat National Hospital, Karachi, from May 2006 to February 2007.
Sixty patients meeting the inclusion criteria were randomly allocated in two groups of 30 patients each. One and a half ml of 0.75% hyperbaric bupivacaine was injected with free flow of cerebrospinal fluid using a 23 gauge quincke needle. Lumbar puncture was performed in the sitting position at 3 - 4 or 4 - 5 lumbar interspace. Patients were then assigned to the supine or lateral decubitus position for 10 minutes. Heart rate, systolic, mean and diastolic blood pressures of patients were recorded with their pre-anaesthesia readings in the 1st, 5th, 15th, 30th and then at every 15th minute till the end of procedure. Recovery room readings were also taken.
The systolic, mean and diastolic blood pressure changes were significant in both groups. But from 1st minute to recovery room, statistically significant difference (p < 0.05) was found at each time interval, the unilateral groups (group A) being more stable with respect to pre-anaesthesia readings. The decrease in heart rate was comparable in both groups.
Unilateral spinal anaesthesia was associated with a more stable cardiovascular profile, therefore, it is a valuable technique for high risk patients.
通过术前记录评估接受单侧和双侧脊髓麻醉患者的血流动力学变化。
准实验研究。
2006年5月至2007年2月，卡拉奇利亚卡特国家医院主手术室。
60名符合纳入标准的患者被随机分为两组，每组30名。使用23号昆克针在脑脊液自由流动时注入1.5毫升0.75%的高压布比卡因。在第3 - 4或4 - 5腰椎间隙坐位进行腰椎穿刺。然后让患者仰卧或侧卧10分钟。记录患者在第1、5、15、30分钟以及此后每隔15分钟直至手术结束时的心率、收缩压、平均压和舒张压，并与术前读数进行比较。同时记录恢复室的读数。
两组患者的收缩压、平均压和舒张压变化均有统计学意义。但从第1分钟到恢复室，在每个时间间隔均发现有统计学显著差异（p < 0.05），单侧组（A组）相对于术前读数更稳定。两组心率下降情况相当。
单侧脊髓麻醉与更稳定的心血管状况相关，因此，对于高危患者是一种有价值的技术。
