Bischoff U, Nolte H
Reg Anaesth. 1986 Jul;9(3):60-3.
The safety of bupivacaine in respect of its cardiotoxicity has been discussed recently. Especially the concentration of bupivacaine 0.75% has been heavily criticized, first of all in obstetrical anaesthesia. Therefore two groups of patients receiving bupivacaine 0.5% and bupivacaine 0.75% were compared according to complications and side effects related to the local anaesthetic. 749 patients undergoing varicose vein stripping were divided in two groups: 371 patients received bupivacaine 0.5% with adrenalin 1:200,000 and 378 patients bupivacaine 0.75% with POR-8 (0.1 i.U./ml) for epidural anaesthesia. The average age was 46 years (20-71 y.). The average height 168 cm (149-196 cm), and the average weight 72 kg (40-99 kg). There were 68.7% female and 31.3% male patients in these groups. The anaesthesia charts of these patients were evaluated retrospectively. The incidence of hypotension, breadycardia, tachycardia, extrasystoles, vomiting and muscle twirching were taken as side effects. The two groups were compared. The results showed in relation to age, risk-grouping and the dosage/kg no evidence of an increased cardiotoxicity of the higher concentration of bupivacaine. Thus bupivacaine 0.75% does not show any increase in complications or side effects as long as its application is done correctly.
最近讨论了布比卡因在心脏毒性方面的安全性。尤其是0.75%的布比卡因浓度受到了严厉批评，首先是在产科麻醉中。因此，根据与局部麻醉剂相关的并发症和副作用，对两组接受0.5%布比卡因和0.75%布比卡因的患者进行了比较。749例接受大隐静脉剥脱术的患者被分为两组：371例患者接受含1:200,000肾上腺素的0.5%布比卡因，378例患者接受含POR - 8（0.1国际单位/毫升）的0.75%布比卡因用于硬膜外麻醉。平均年龄为46岁（20 - 71岁）。平均身高168厘米（149 - 196厘米），平均体重72千克（40 - 99千克）。这些组中女性患者占68.7%，男性患者占31.3%。对这些患者的麻醉记录进行了回顾性评估。将低血压、心动过缓、心动过速、早搏、呕吐和肌肉抽搐的发生率作为副作用。对两组进行了比较。结果显示，就年龄、风险分组和每千克剂量而言，没有证据表明较高浓度的布比卡因会增加心脏毒性。因此，只要正确使用，0.75%的布比卡因在并发症或副作用方面没有任何增加。
