Mansourian Afshin, Askarzadeh Mohammad, Shabani Mohammad, Divsalar Kouros
Resident, Department of Anesthesiology, Kerman University of Medical Sciences, Kerman, Iran.
Assistant Professor, Department of Anesthesiology, Kerman University of Medical Sciences, Kerman, Iran.
Addict Health. 2012 Summer-Autumn;4(3-4):95-101.
Duration of spinal anesthesia depends on the type of anesthetic agent, dosage and additive materials such as epinephrine, ephedrine and opioid. We compared the duration of spinal anesthesia with lidocaine 5% with or without epinephrine in addict and non-addict patients undergoing inferior limb fracture surgery.
This single blinded randomized clinical trial was performed on 201 males (height ranged 150-180 cm) who referred to the Shahid Bahonar Hospital of Kerman for the inferior limb fracture. Their physical class was matched to the American association standard class 1 and 2, and they were appropriate candidates for the spinal anesthesia. The addict or non-addict groups were each divided into two subgroups. 75 mg of 5% lidocaine was prescribed for one subgroup, and the other subgroup received 75 mg of 5% lidocaine plus 0.2 mg epinephrine. The level of primary anesthesia was elevated to T6. Duration of returning to the 4 primary sensory levels was measured since baseline.
A significant increase in the duration of anesthesia level in both addict and non-addict patients receiving lidocaine plus epinephrine was observed compared to the subgroups receiving lidocaine alone (P < 0.01). Duration of decrease in sensory level in addict subgroups receiving lidocaine or lidocaine plus epinephrine was lower compared to non-addict patients (P < 0.001). In addict subgroup receiving lidocaine alone, a significant decrease was observed in the time needed for decrease in sensory level (P < 0.01).
According to the results of this study, regardless of the anesthetic agent being used, duration of spinal anesthesia was shorter in addict patients compared to non-addict ones. Addition of epinephrine to lidocaine 5% increased the duration of spinal anesthesia in both addict and non-addict patients.
脊髓麻醉的持续时间取决于麻醉剂的类型、剂量以及诸如肾上腺素、麻黄碱和阿片类药物等添加剂。我们比较了在接受下肢骨折手术的成瘾和非成瘾患者中，使用含或不含肾上腺素的5%利多卡因进行脊髓麻醉的持续时间。
这项单盲随机临床试验对201名男性（身高在150 - 180厘米之间）进行，这些男性因下肢骨折前往克尔曼的沙希德·巴霍纳尔医院就诊。他们的身体状况符合美国麻醉医师协会标准1级和2级，是脊髓麻醉的合适人选。成瘾组和非成瘾组各自又分为两个亚组。一个亚组给予75毫克5%利多卡因，另一个亚组给予75毫克5%利多卡因加0.2毫克肾上腺素。将初始麻醉平面提升至T6。从基线开始测量恢复到4个初始感觉平面的时间。
与仅接受利多卡因的亚组相比，接受利多卡因加肾上腺素的成瘾和非成瘾患者的麻醉平面持续时间均显著增加（P < 0.01）。与非成瘾患者相比成瘾亚组接受利多卡因或利多卡因加肾上腺素后感觉平面下降的持续时间更短（P < 0.001）。在仅接受利多卡因的成瘾亚组中，感觉平面下降所需时间显著减少（P < 0.01）。
根据本研究结果，无论使用何种麻醉剂，成瘾患者的脊髓麻醉持续时间比非成瘾患者短。在5%利多卡因中添加肾上腺素可增加成瘾和非成瘾患者的脊髓麻醉持续时间。
