Sheskey M C, Rocco A G, Bizzarri-Schmid M, Francis D M, Edstrom H, Covino B G
Anesth Analg. 1983 Oct;62(10):931-5.
A randomized double-blind study was performed to elucidate the interrelationships among volume, concentration, and dosage of bupivacaine administered intrathecally. Sixty male patients between the ages of 40 and 80 years having transurethral surgery in the lithotomy position were studied using 10-, 15-, and 20-mg doses of glucose-free bupivacaine as either a 0.5 or a 0.75% solution. Success rate, time of onset and duration of anaglesia and motor block, and cardiovascular responses were assessed. It was found that both 15 and 20 mg of either concentration of bupivacaine provide satisfactory spinal anesthesia for transurethral urologic procedures. However, three of 20 patients receiving the 10-mg dose required supplementation with general anesthesia. Comparison of various volumes and concentrations of bupivacaine indicates that total dosage of bupivacaine is more important than volume or concentration. In several patients with sensory block involving cervical dermatomes, there was no significant hypotension or bradycardia, which suggests that cardiac output and venous return were maintained, perhaps because of the use of lithotomy position.
进行了一项随机双盲研究，以阐明鞘内注射布比卡因的容量、浓度和剂量之间的相互关系。对60例年龄在40至80岁之间、处于截石位接受经尿道手术的男性患者进行了研究，使用10毫克、15毫克和20毫克不含葡萄糖的布比卡因，分别配制成0.5%或0.75%的溶液。评估了成功率、镇痛和运动阻滞的起效时间及持续时间，以及心血管反应。结果发现，两种浓度的15毫克和20毫克布比卡因均能为经尿道泌尿外科手术提供满意的脊髓麻醉。然而，接受10毫克剂量的20例患者中有3例需要补充全身麻醉。布比卡因不同容量和浓度的比较表明，布比卡因的总剂量比容量或浓度更重要。在几例感觉阻滞累及颈部皮节的患者中，未出现明显的低血压或心动过缓，这表明心输出量和静脉回流得以维持，可能是因为采用了截石位。
