Kristensen J, Helbo-Hansen H S, Toft P, Hole P
Department of Anaesthesia, Odense University Hospital, Denmark.
Acta Anaesthesiol Scand. 1989 Jan;33(1):53-7. doi: 10.1111/j.1399-6576.1989.tb02859.x.
Spinal anaesthesia with 2, 3 or 4 ml of glucose-free 2% lignocaine was studied in 64 patients undergoing transurethral surgery of the bladder. Cephalad spread of analgesia, onset time, duration of analgesia, duration of motor block, quality of analgesia, and the cardiovascular effects were assessed. Two ml of 2% lignocaine was insufficient to produce reliable analgesia. Three ml provided sufficient analgesia in most of the patients, but 4 ml was needed to guarantee sufficient analgesia in all patients. Onset times for analgesia and motor block were 10-20 min. After 4 ml the median and interquartile values were: maximum cephalad spread: T8, (T10-T5); time from injection to regression of analgesia to T11: 84 min, (60-103 min); duration of complete motor block: 90 min, (60-120 min). All patients in the 3-ml and 4-ml groups developed complete motor block. There was a positive correlation between the dose and the duration of analgesia and motor block. A positive correlation, although weaker, was also seen between the dose and the maximum cephalad spread of analgesia. There was an inverse relationship between the cephalad spread of analgesia and the duration of motor block. Falls in systolic blood pressure greater than 30% were noted in seven patients in whom the cephalad spread of analgesia was higher than in the rest of the patients. Spinal anaesthesia with glucose-free 2% lignocaine in doses of 3-4 ml provides reliable analgesia for transurethral surgery of the bladder.
对64例接受膀胱经尿道手术的患者进行了研究，采用2、3或4毫升无葡萄糖的2%利多卡因进行脊髓麻醉。评估了镇痛的头端扩散、起效时间、镇痛持续时间、运动阻滞持续时间、镇痛质量和心血管效应。2毫升2%利多卡因不足以产生可靠的镇痛效果。3毫升对大多数患者提供了足够的镇痛，但所有患者都需要4毫升才能保证足够的镇痛。镇痛和运动阻滞的起效时间为10 - 20分钟。注射4毫升后，中位数和四分位数间距值为：最大头端扩散：T8，(T10 - T5)；从注射到镇痛消退至T11的时间：84分钟，(60 - 103分钟)；完全运动阻滞持续时间：90分钟，(60 - 120分钟)。3毫升和4毫升组的所有患者均出现完全运动阻滞。剂量与镇痛和运动阻滞持续时间之间存在正相关。剂量与镇痛的最大头端扩散之间也存在正相关，尽管较弱。镇痛的头端扩散与运动阻滞持续时间之间存在负相关。7例患者的镇痛头端扩散高于其他患者，其收缩压下降超过30%。采用3 - 4毫升无葡萄糖的2%利多卡因进行脊髓麻醉可为膀胱经尿道手术提供可靠的镇痛。
