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0.5%重比重布比卡因用于椎管内麻醉的感觉阻滞水平预测:一项回顾性研究。

Sensory block level prediction of spinal anaesthesia with 0.5% hyperbaric bupivacaine: a retrospective study.

机构信息

Department of Anesthesiology, Cheng Hsin General Hospital, Taipei, Taiwan.

Department of Biomedical Engineering, Ming Chuan University, Taoyuan, Taiwan.

出版信息

Sci Rep. 2021 Apr 27;11(1):9105. doi: 10.1038/s41598-021-88726-2.

Abstract

There is still no consensus on how to determine the dose of spinal anaesthesia with adequate sensory block for a planned surgery. This retrospective study aimed to explore the associations of miscellaneous factors with peak sensory block level after spinal anaesthesia with hyperbaric bupivacaine, and to construct a predictive model for single-shot spinal anaesthesia. We collected the records of 401 non-pregnant adults who underwent spinal anaesthesia with 0.5% hyperbaric bupivacaine at the L3-4 or L4-5 intervertebral space for lower body surgeries. Multiple linear regression analysis was used to investigate predictors of the block level and build up the predictive model. Five variables were identified as independent predictors of the peak sensory block level, including bupivacaine dose, height, weight, gender and age. The predictive model for peak block level after spinal anaesthesia could be expressed as a formula with these five variables and the estimated predictive power was 0.72. Based on this model, it is possible to determine a reasonable dose of hyperbaric bupivacaine for spinal anaesthesia, which gives adequate sensory block required for diverse surgical procedures in various patients and could be considered as a dose reference for sensory block height in spinal anaesthesia.

摘要

目前对于如何确定椎管内麻醉中用于计划手术的足够感觉阻滞的剂量,尚无共识。本回顾性研究旨在探讨在使用重比重布比卡因行单次蛛网膜下腔麻醉后,各种因素与感觉阻滞最高水平的相关性,并构建单次蛛网膜下腔麻醉的预测模型。我们收集了 401 例非妊娠成年人的记录,这些成年人在 L3-4 或 L4-5 椎间隙接受 0.5%重比重布比卡因行下半身手术的椎管内麻醉。采用多元线性回归分析来研究阻滞水平的预测因素,并建立预测模型。有 5 个变量被确定为感觉阻滞最高水平的独立预测因子,包括布比卡因剂量、身高、体重、性别和年龄。椎管内麻醉后感觉阻滞最高水平的预测模型可以用这 5 个变量和估计的预测能力表示为一个公式,为 0.72。基于该模型,可以确定重比重布比卡因用于椎管内麻醉的合理剂量,该剂量可为各种手术提供所需的足够感觉阻滞,并且可以被视为椎管内麻醉感觉阻滞高度的剂量参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fe2/8079681/f22adb02d8c5/41598_2021_88726_Fig1_HTML.jpg

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