Meijer J, de Lange J J, Ros H H
Department of Anesthesiology, Free University Hospital, Amsterdam, The Netherlands.
Anesth Analg. 1988 Apr;67(4):356-9.
The effectiveness of pulse wave monitoring of the big toes was compared with loss of cold discrimination to determine the onset of nerve blockade during lumbar epidural and spinal anesthesia. Forty-seven patients scheduled for elective urologic or lower extremity operations were assigned to one of three groups. Group 1 (15 patients) received epidural mepivacaine 1.5% with epinephrine; group 2 (12 patients), epidural bupivacaine 0.5%, and group 3 (20 patients), spinal bupivacaine 0.5%. In the epidural groups, the mean time to onset of increases in pulse wave amplitude was less than half the mean time to onset of decrease in cold discrimination (P less than 0.05). In patients given spinal anesthesia, there was no significant difference. The pulse wave monitor seems to be a sensitive and objective detector of early anesthetic effect during spinal and epidural anesthesia.
比较大脚趾脉搏波监测与冷觉辨别丧失在确定腰段硬膜外麻醉和脊髓麻醉期间神经阻滞开始时间方面的有效性。47例计划行择期泌尿外科或下肢手术的患者被分为三组。第1组（15例患者）接受含肾上腺素的1.5%甲哌卡因硬膜外麻醉；第2组（12例患者）接受0.5%布比卡因硬膜外麻醉，第3组（20例患者）接受0.5%布比卡因脊髓麻醉。在硬膜外麻醉组中，脉搏波振幅增加开始的平均时间不到冷觉辨别减退开始平均时间的一半（P<0.05）。在接受脊髓麻醉的患者中，差异无统计学意义。脉搏波监测仪似乎是脊髓麻醉和硬膜外麻醉期间早期麻醉效果的敏感且客观的检测器。
