Venn P J, Simpson D A, Rubin A P, Edstrom H H
Department of Anaesthesia, Charing Cross Hospital, London.
Br J Anaesth. 1989 Dec;63(6):682-7. doi: 10.1093/bja/63.6.682.
We studied the effect on systemic arterial pressure of fluid preloading with 1 litre of crystalloid fluid before spinal anaesthesia in 40 patients undergoing minor lower abdominal or lower limb surgery. Fluid was given at a rate of either 1 ml min-1 (no preload group), or 1000 ml in the 15 min (preload group) immediately before induction of spinal anaesthesia with 3 ml of 0.75% glucose-free bupivacaine. There was no difference between the groups in the character of anaesthesia or motor block in the lower limbs. The cephalad spread of analgesia ranged from L1 to C8. Analgesia was insufficient for surgery without supplementary analgesia in three patients in each group. The group not given a fluid preload had significantly lower arterial pressures (P less than 0.05) when anaesthesia extended above the T5 dermatome. The mean time before the lowest arterial pressure was recorded was twice as long in the preloaded group as in the non-preloaded group. Glucose-free 0.75% bupivacaine did not give a reliable extent of anaesthesia for lower abdominal surgery.
我们研究了在40例接受下腹部或下肢小手术的患者中，于脊髓麻醉前用1升晶体液进行液体预负荷对体循环动脉压的影响。在使用3毫升0.75%无糖布比卡因诱导脊髓麻醉前即刻，液体以1毫升/分钟的速率给予（无预负荷组），或以15分钟内输注1000毫升的速率给予（预负荷组）。两组在麻醉特征或下肢运动阻滞方面无差异。镇痛的头端扩散范围从L1至C8。每组各有3例患者在无辅助镇痛的情况下镇痛不足以进行手术。当麻醉范围扩展至T5皮节以上时，未进行液体预负荷的组动脉压显著更低（P<0.05）。记录到最低动脉压之前的平均时间，预负荷组是未预负荷组的两倍。0.75%无糖布比卡因对下腹部手术而言麻醉范围不可靠。
