Finucane B T, Yilling F
Department of Anesthesiology, Grady Memorial Hospital, Atlanta, Georgia 30335.
Anesthesiology. 1989 Mar;70(3):401-3. doi: 10.1097/00000542-198903000-00005.
The incidence of failed local anesthetic axillary blockade varies but can be as high as 20-30%. The authors propose to evaluate the safety of supplementing an axillary block with mepivacaine 30 min after the initial injection. An axillary blockade was performed on 10 healthy patients scheduled for forearm or hand surgery using a new catheter technique. Mepivacaine 1% with epinephrine (7 mg/kg) was administered initially and followed 30 min later by half the original dose (3.5 mg/kg). Plasma levels of mepivacaine were estimated at frequent intervals for 5 h after the initial injection. There were no symptoms or signs of local anesthetic toxicity, and plasma levels of mepivacaine remained below those that usually caused symptoms. In conclusion, the authors conclude that mepivacaine 1% with epinephrine (10.5 mg/kg) can be safely administered in divided doses into the axillary sheath within a 31-min period.
局部麻醉腋路阻滞失败的发生率各不相同，但可能高达20% - 30%。作者提议评估在初次注射30分钟后用甲哌卡因补充腋路阻滞的安全性。使用一种新的导管技术，对10例计划进行前臂或手部手术的健康患者实施腋路阻滞。最初给予含肾上腺素的1%甲哌卡因（7mg/kg），30分钟后给予初始剂量的一半（3.5mg/kg）。在初次注射后5小时内频繁测定甲哌卡因的血浆水平。未出现局部麻醉药毒性的症状或体征，且甲哌卡因的血浆水平仍低于通常引起症状的水平。总之，作者得出结论，含肾上腺素的1%甲哌卡因（10.5mg/kg）可在31分钟内分剂量安全地注入腋鞘。
