Haasio J, Hiippala S, Rosenberg P H
Department of Anaesthesia, Surgical Hospital, Helsinki University Central Hospital, Finland.
Anaesthesia. 1989 Jan;44(1):19-21. doi: 10.1111/j.1365-2044.1989.tb11090.x.
The effects of different techniques of exsanguination of the upper arm during intravenous regional anaesthesia on prilocaine plasma concentrations, quality of anaesthesia, toxic symptoms after deflation of the tourniquet and injection pressure of the anaesthetic were studied in 10 healthy male volunteers. The nondominant arm was exsanguinated using either Esmarch's bandage or elevation of the arm for 2 minutes plus arterial occlusion by compression of the brachial artery. The injection pressure after the prilocaine dose (3 mg/kg) was significantly higher in the elevation group (maximally 98 mmHg). There were no statistically significant differences in the onset of, or recovery from, anaesthesia between the groups. Various mild toxic symptoms were experienced in the central nervous system after deflation of the tourniquet. However, there was no correlation between the two techniques and the degree of severity of the toxic symptoms. The highest single venous plasma concentration (total) of prilocaine was 2.3 micrograms/ml measured from the contralateral cubital vein (elevation group, 2 minutes). The differences in prilocaine concentrations between the groups were not statistically significant.
在10名健康男性志愿者中，研究了静脉区域麻醉期间上臂不同放血技术对丙胺卡因血浆浓度、麻醉质量、止血带放气后的毒性症状以及麻醉剂注射压力的影响。非优势臂使用Esmarch绷带或抬高手臂2分钟并通过压迫肱动脉进行动脉闭塞来放血。丙胺卡因剂量（3mg/kg）后的注射压力在抬高组中显著更高（最高98mmHg）。两组之间麻醉的起效或恢复没有统计学上的显著差异。止血带放气后，中枢神经系统出现了各种轻度毒性症状。然而，两种技术与毒性症状的严重程度之间没有相关性。从对侧肘静脉（抬高组，2分钟）测得的丙胺卡因最高单次静脉血浆浓度（总计）为2.3微克/毫升。两组之间丙胺卡因浓度的差异没有统计学意义。
