Pierce E T, Denson D D, Essell S K, Santos D J, Edstrom H H
Department of Anesthesia, University of Cincinnati College of Medicine, OH 45267-0531.
Reg Anesth. 1989 Jan-Feb;14(1):31-4.
The authors previously reported that if a loading dose of 50 mg bupivacaine was followed by infusion of 0.0625% bupivacaine (12.5 mg/hr), supplemental doses to achieve satisfactory analgesia for labor and delivery were required in 50% of patients. The current study was done to determine whether increasing the dose from 12.5 to 25 mg/h would eliminate the need for supplemental injections. Twenty-three healthy parturients were randomly assigned to one of two groups--Group I: 0.125% bupivacaine at 20 ml/hr (25 mg/hr); or Group II: 0.25% bupivacaine at 10 ml/hr (25 mg/hr). Taking both groups together, the 50-mg bupivacaine loading dose followed by 25 mg/hr provided adequate analgesia for labor and delivery in 74% of the patients. Two parturients in Group I and three in Group II required supplemental boluses of 4 ml of 0.5% bupivacaine for delivery. Pharmacokinetic data were similar in both groups. Using a dose of 25 mg/hr resulted in 74% of the patients obtaining adequate analgesia for labor and delivery. This improvement over the 50% success rate in the previous study, was achieved without any evidence of toxicity.
作者之前报告称，如果先给予50毫克布比卡因负荷剂量，随后以0.0625%布比卡因（12.5毫克/小时）输注，50%的患者需要补充剂量以达到令人满意的分娩镇痛效果。本研究旨在确定将剂量从12.5毫克/小时增加到25毫克/小时是否能消除补充注射的必要性。23名健康产妇被随机分为两组之一——第一组：以20毫升/小时（25毫克/小时）输注0.125%布比卡因；或第二组：以10毫升/小时（25毫克/小时）输注0.25%布比卡因。两组综合来看，50毫克布比卡因负荷剂量后以25毫克/小时输注，74%的患者在分娩时获得了足够的镇痛效果。第一组有两名产妇和第二组有三名产妇在分娩时需要补充4毫升0.5%布比卡因推注。两组的药代动力学数据相似。使用25毫克/小时的剂量，74%的患者在分娩时获得了足够的镇痛效果。与之前研究中50%的成功率相比，这一改善在没有任何毒性迹象的情况下得以实现。
