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哌替啶作为脊髓麻醉剂:与利多卡因-葡萄糖的比较。

Meperidine as a spinal anesthetic agent: a comparison with lidocaine-glucose.

作者信息

Sangarlangkarn S, Klaewtanong V, Jonglerttrakool P, Khankaew V

出版信息

Anesth Analg. 1987 Mar;66(3):235-40.

PMID:3548485
Abstract

The anesthetic effect of 2 ml of 5% lidocaine in 7.5% glucose (LG) or 5% meperidine in water were evaluated and compared in 40 ASA class 1 or 2 patients. Patients were randomly assigned to one of the two groups (20 patients in each) according to the anesthetic agent, which was injected into the lumbar subarachnoid space in the sitting position. The patients remained sitting for 5 min before being placed in the supine position. Times of onset of sensory and complete motor blockade were significantly more rapid with LG. The extent of maximum cephalad spread of analgesia and the time to maximum height of analgesia in the two groups were not different. Duration of analgesia at the T-7 (48.96 +/- 6.64 min with LG, 44.74 +/- 6.14 min with meperidine; means +/- SEM) and L-1 (94.37 +/- 7.42 min with LG, 76.19 +/- 5.64 min with meperidine) dermatomes was not different in the two groups but was statistically longer at the T-10 dermatome with LG (66.83 +/- 6.72 min) than with meperidine (46.66 +/- 6.26 min). The duration of complete motor blockade was also significantly longer with LG (66.44 +/- 7.05 min) than with meperidine (42.67 +/- 4.47 min). Complications in both groups included decrease in blood pressure and nausea and vomiting intraoperatively, and urinary retention, nausea and vomiting, and mild headache postoperatively. Complications that occurred only in the meperidine group were intraoperative drowsiness, respiratory depression, bronchospasm, and itching. The frequency of complications was greater wit meperidine.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在40例美国麻醉医师协会(ASA)分级为1或2级的患者中,评估并比较了2毫升5%利多卡因溶于7.5%葡萄糖溶液(LG)或5%哌替啶溶于水后的麻醉效果。根据麻醉剂将患者随机分为两组(每组20例),麻醉剂于坐位时注入腰蛛网膜下腔。患者保持坐位5分钟后再改为仰卧位。LG组感觉和完全运动阻滞的起效时间明显更快。两组镇痛的最大头端扩散范围和达到最大镇痛高度的时间无差异。两组在T-7(LG组为48.96±6.64分钟,哌替啶组为44.74±6.14分钟;均值±标准误)和L-1(LG组为94.37±7.42分钟,哌替啶组为76.19±5.64分钟)皮节的镇痛持续时间无差异,但在T-10皮节,LG组(66.83±6.72分钟)的镇痛持续时间比哌替啶组(46.66±6.26分钟)在统计学上更长。LG组完全运动阻滞的持续时间也明显长于哌替啶组(分别为66.44±7.05分钟和42.67±4.47分钟)。两组的并发症包括术中血压下降、恶心和呕吐,以及术后尿潴留、恶心和呕吐、轻度头痛。仅在哌替啶组出现的并发症有术中嗜睡、呼吸抑制、支气管痉挛和瘙痒。哌替啶组并发症的发生率更高。(摘要截短于250字)

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