Vester-Andersen T, Husum B, Lindeburg T, Borrits L, Gøthgen I
Acta Anaesthesiol Scand. 1984 Dec;28(6):612-6. doi: 10.1111/j.1399-6576.1984.tb02131.x.
Perivascular axillary blockade was performed on 60 patients with the aid of a catheter technique. The patients were randomly allocated to two groups. All patients received the same dose of local anaesthetic: 60 ml of mepivacaine 1% with adrenaline, but one group received the dose as a bolus injection, whereas the other group received the dose as fractional injections of 30 + 30 ml with an interval of 20 min. Blood concentrations of mepivacaine were measured up to 90 min after injection of local anaesthetic. Sensory and motor blockade were evaluated 20, 30 and 40 min after injection. Forty minutes after the last injection of local anaesthetic, there was no difference between the blockades of the two groups, except for the sensory blockade of the lower lateral cutaneous nerve of the arm, in which the frequency of analgesia was 90% after bolus injection and 63% after fractional injections. There was no difference in blood concentrations of mepivacaine between the two groups. None of the 60 patients showed any sign of systemic toxic reactions. Fractional injection of local anaesthetic in perivascular axillary blockade does not offer any advantage over bolus injection with regard to the resulting blockade.
在导管技术辅助下，对60例患者实施了血管周围腋路阻滞。患者被随机分为两组。所有患者均接受相同剂量的局部麻醉药：60毫升1%含肾上腺素的甲哌卡因，但一组接受单次推注给药，而另一组接受30 + 30毫升分次注射给药，间隔20分钟。在注射局部麻醉药后长达90分钟内测定甲哌卡因的血药浓度。在注射后20、30和40分钟评估感觉和运动阻滞情况。在最后一次注射局部麻醉药40分钟后，两组阻滞情况无差异，除了臂外侧下皮神经的感觉阻滞，单次推注给药后镇痛频率为90%，分次注射给药后为63%。两组甲哌卡因的血药浓度无差异。60例患者均未出现任何全身毒性反应迹象。在血管周围腋路阻滞中，局部麻醉药分次注射在产生的阻滞效果方面并不比单次推注给药有任何优势。
