Writer W D, Dewan D M, James F M
Can Anaesth Soc J. 1984 Sep;31(5):559-64. doi: 10.1007/BF03009543.
We evaluated 2-chloroprocaine, three per cent, in 44 women having epidural anaesthesia for Caesarean section. All subjects received a minimum dose of 25 ml (750 mg) in increments designed to allow early recognition of accidental subarachnoid or intravascular injection. Further increments were given as needed to achieve a T5 sensory level or higher. We recorded pulse and blood pressure at two-minute intervals and used a simple pain scale to assess analgesia. Ninety-three per cent of subjects had acceptable analgesia. Seventeen mothers required more than 25 ml to attain a T5 level; subjects having a BMI (body mass index) equal to or greater than 35, or over 35 years of age, demonstrated more cephalad spread. Hypotension (MAP 80 per cent of control or less) occurred in 24, mothers (54 per cent), often transiently, but an infused fluid volume exceeding 30 ml X kg-1 at delivery significantly reduced post-delivery hypotension. Nausea and vomiting accompanied the hypotension in 12 mothers. No neonatal depression occurred. We conclude the incremental administration of chloroprocaine, as described, permits safe administration of the drug, with excellent analgesia in most parturients.
我们对44名接受剖宫产硬膜外麻醉的女性使用了3%的2-氯普鲁卡因进行评估。所有受试者均接受最小剂量25毫升（750毫克），并逐步增加剂量，以便能早期识别意外蛛网膜下腔或血管内注射情况。根据需要进一步增加剂量，以达到T5感觉平面或更高。我们每隔两分钟记录脉搏和血压，并使用简单的疼痛量表评估镇痛效果。93%的受试者镇痛效果良好。17名母亲需要超过25毫升才能达到T5平面；体重指数（BMI）等于或大于35或年龄超过35岁的受试者，其麻醉平面向上扩散更明显。24名母亲（54%）出现低血压（平均动脉压为对照值的80%或更低），且多为短暂性低血压，但分娩时输液量超过30毫升/千克可显著降低产后低血压的发生率。12名母亲在低血压的同时伴有恶心和呕吐。未发生新生儿抑制情况。我们得出结论，如所述逐步给予氯普鲁卡因可使该药物安全给药，且大多数产妇镇痛效果良好。
