Stark P, Nolte H
Anaesthesist. 1978 May;27(5):suppl 41-3.
This study was initiated by other authors who found that bupivacaine precipitated together with spinal fluid in vitro and who assumed that during spinal anaesthesia complications might be possible. Under the influence of several local anaesthetic agents the pH of the spinal fluid and in 160 cases the precipitation was examined. There was no precipitation. The experimental conditions were nearly in vivo conditions. The results differed clearly from those in vitro. While in vitro bupivacaine precipitated from a pH higher than 7.37 in concentrations higher than 0.8 mg/ml [2], the pH of the spinal fluid in vivo was lower than 7.35 continually and the concentration of bupivacaine not higher than 0.3 mg/ml. This means that the border of bupivacaine precipitation is by far not reached in vivo and that complications therefore are not possible.
本研究由其他作者发起,他们发现布比卡因在体外可与脑脊液一起沉淀,并认为在脊髓麻醉期间可能会出现并发症。在几种局部麻醉剂的作用下,对脑脊液的pH值进行了检测,并在160例病例中检查了沉淀情况。未出现沉淀。实验条件几乎等同于体内条件。结果与体外实验明显不同。虽然在体外,当pH值高于7.37且布比卡因浓度高于0.8 mg/ml时会出现沉淀[2],但体内脑脊液的pH值持续低于7.35,布比卡因浓度不高于0.3 mg/ml。这意味着在体内远未达到布比卡因沉淀的界限,因此不会出现并发症。