Stienstra R, Gielen M, van Poorten F, Kroon J W
Department of Anesthesiology, Reinier de Graaf Gasthuis, Delft, The Netherlands.
Anesth Analg. 1989 Nov;69(5):593-7.
Onset (defined as the time between injection and achievement of the highest level of sensory blockade), duration, and regression of sensory and motor blockade after the intrathecal administration of 3 mL plain bupivacaine 0.5%, previously equilibrated to either 37 degrees C or 20 degrees C, were studied in two groups of 20 patients. In patients receiving the solution equilibrated to 37 degrees C, the maximum level of sensory blockade was significantly higher (T 4.6 vs T 7.5), variability was smaller (SEM 0.33 vs 0.58), and duration of the sensory level of blockade at or above T 6, T 8, and T 10 was significantly longer (56 min vs 20 min, 101 min vs 59 min, and 131 min vs 77 min, respectively). There were no significant differences with regard to onset of sensory and motor blockade or either the time needed both for the sensory level of blockade to regress two segments from its highest level and to the first lumbar segment, or the duration of complete motor blockade of the lower limbs. It is concluded that the intrathecal administration of a bupivacaine solution previously equilibrated to 37 degrees C as compared with a solution injected at room temperature results in a higher, more predictable maximum sensory level of blockade with longer duration at or above T 6, T 8, and T 10.
在两组各20例患者中，研究了鞘内注射3毫升0.5%布比卡因原液（预先分别平衡至37℃或20℃）后的起效时间（定义为注射至达到最高感觉阻滞水平的时间）、持续时间以及感觉和运动阻滞的消退情况。在接受平衡至37℃溶液的患者中，最大感觉阻滞水平显著更高（T4.6对T7.5），变异性更小（标准误0.33对0.58），且在T6、T8和T10及以上水平的感觉阻滞持续时间显著更长（分别为56分钟对20分钟、101分钟对59分钟、131分钟对77分钟）。在感觉和运动阻滞的起效时间、感觉阻滞水平从最高水平消退两个节段至第一腰段所需的时间或下肢完全运动阻滞的持续时间方面，均无显著差异。结论是，与在室温下注射的溶液相比，鞘内注射预先平衡至37℃的布比卡因溶液会导致更高、更可预测的最大感觉阻滞水平，且在T6、T8和T10及以上水平持续时间更长。
