Lv M, Zhang P, Wang Z
Department of Obestetrics and Gynecology, Affiliated Women and Children's Hospital of Jiaxing University, Jiaxing, China.
Department of Anesthesiology, Affiliated Women and Children's Hospital of Jiaxing University, Jiaxing, China.
J Pain Res. 2018 Nov 8;11:2791-2796. doi: 10.2147/JPR.S174176. eCollection 2018.
It was reported that epidural volume extension could decrease the ED of intrathecal plain bupivacaine. In this study, we investigated the ED of intrathecal hyperbaric ropivacaine followed by epidural normal saline bolus for cesarean section.
Sixty parturients were allocated into two groups in this prospective study. About 10 mL of epidural normal saline was given after the intrathecal dose of hyperbaric ropivacaine in the Group S (normal saline group), and no epidural injection of normal saline was given after the intrathecal ropivacainve injection in the Group C (control group). The dose of intrathecal ropivacaine for each parturient was decided by up-down allocation method. The initial dose was set as 10 mg. Effective anesthesia was defined as the level of T6 or above achieved within 10 minutes after intrathecal injection and no additional epidural drug to complete operation. The Massey formula was applied to calculate the ED of intrathecal ropivacaine.
The ED of intrathecal ropivacaine for cesarean section determined by up-and-down method was 7.51 mg (95% CI, 7.09-7.93 mg) in the Group S and 8.29 mg (95% CI, 7.73-8.85 mg) in the Group C, and there was a significant difference in ED of ropivacaine between the two groups (<0.05). Compared with the Group C, the ED of intrathecal ropivacaine decreased when followed by epidural normal saline bolus.
The ED of intrathecal hyperbaric ropivacaine for cesarean section is 8.29 mg, and it is reduced when followed by epidural normal saline bolus (www.chictr.org.cn, registration number: ChiCTR-ROC-17013382).
据报道，硬膜外容量扩展可降低鞘内注射普通布比卡因的有效剂量（ED）。在本研究中，我们调查了剖宫产时鞘内注射重比重罗哌卡因后再推注硬膜外生理盐水时鞘内重比重罗哌卡因的有效剂量。
在这项前瞻性研究中，60名产妇被分为两组。S组（生理盐水组）在鞘内注射重比重罗哌卡因后给予约10 mL硬膜外生理盐水，C组（对照组）在鞘内注射罗哌卡因后不给予硬膜外生理盐水注射。每位产妇鞘内罗哌卡因的剂量通过上下分配法确定。初始剂量设定为10 mg。有效麻醉定义为鞘内注射后10分钟内达到T6及以上平面且无需额外硬膜外药物即可完成手术。应用梅西公式计算鞘内罗哌卡因的有效剂量。
通过上下法确定的剖宫产鞘内罗哌卡因有效剂量在S组为7.51 mg（95%CI，7.09 - 7.93 mg），在C组为8.29 mg（95%CI，7.73 - 8.85 mg），两组罗哌卡因有效剂量有显著差异（<0.05）。与C组相比，鞘内注射罗哌卡因后再推注硬膜外生理盐水时，鞘内罗哌卡因的有效剂量降低。
剖宫产时鞘内重比重罗哌卡因的有效剂量为8.29 mg，鞘内注射罗哌卡因后再推注硬膜外生理盐水时有效剂量降低（www.chictr.org.cn，注册号：ChiCTR - ROC - 17013382）。
