Lanz E, Schellenberg B, Theiss D
Anaesthesist. 1979 Apr;28(4):25-31.
4 ml 0.5% solutions of bupivacaine and tetracaine without the addition of a vasoconstrictor, approximately isobaric, were used for spinal anaesthesia on patients in the sitting position. The sensory and motor block due to the two local anesthetics was tested and compared. The mean time on onset of complete analgesia was the same for both local anaesthetics (9 and 11 min), as was also the highest level of analgesia (T10). The duration of maximal extension of analgesia was on an average 45 min longer due to tetracaine (bupivacaine 105 min, tetracaine 150 min). The duration of maximal spread of the blocked sensation of pain, temperature, pressure and touch was similar for each of both local anesthetics. The regression of these sensory qualities, blocked in a dissoaciated manner, took a parallel course. With tetracaine the motor block of the lower extremities developed faster and lasted longer (Bromage 3 for bupivacaine 192 min, for tetracaine 220 min). Motor function and proprioception normalized in a synchronized manner. Isobaric spinal anaesthesia with these two solutions of local anaesthetics was found to be reliable and controllable, especially when administered to the sitting patient. Tetracaine is a good alternative to bupivacaine, currently controversial for intrathecal use.
4毫升不含血管收缩剂的0.5%布比卡因和丁卡因溶液（近似等比重）用于坐位患者的脊髓麻醉。对两种局部麻醉剂产生的感觉和运动阻滞进行了测试和比较。两种局部麻醉剂产生完全镇痛的平均起效时间相同（9分钟和11分钟），镇痛的最高平面也相同（T10）。丁卡因导致的镇痛最大范围持续时间平均比布比卡因长45分钟（布比卡因105分钟，丁卡因150分钟）。两种局部麻醉剂阻断疼痛、温度、压力和触觉感觉的最大范围持续时间相似。这些以分离方式被阻断的感觉特性的消退过程是平行的。丁卡因使下肢运动阻滞发展更快且持续时间更长（布比卡因的布罗玛分级3级持续192分钟，丁卡因持续220分钟）。运动功能和本体感觉以同步方式恢复正常。发现使用这两种局部麻醉剂溶液进行等比重脊髓麻醉是可靠且可控的，尤其是用于坐位患者时。丁卡因是布比卡因的良好替代品，布比卡因目前用于鞘内给药存在争议。
