Wang B C, Hillman D E, Spielholz N I, Turndorf H
Anesth Analg. 1984 Apr;63(4):445-7.
Chronic neurological deficits have been described in patients after presumed accidental subarachnoid injection of 2-chloroprocaine-CE (Nesacaine-CE; N-CE) intended for epidural block. This study investigated the possible role of pure 2-chloroprocaine (2-CP) and sodium bisulfite, two components of Nesacaine-CE, in causing these complications when injected separately into the lumbar subarachnoid space of neurologically intact awake rabbits. Repeated 2-4-mg spinal anesthetic doses of pure 2-CP in lactated Ringer's solution did not produce chronic hindlimb paralysis even though accumulated doses reached 50 mg. However, 1.2-2.4 mg of sodium bisulfite, the antioxidant in N-CE added to prolong shelf-life, resulted in irreversible hindlimb paralysis in 12 out of 14 animals. This amount of bisulfite is contained in 12-24 mg of 2% N-CE. The demonstration that persistent paralysis resulted from low dosages of sodium bisulfite contained in commercially available 2-CP requires reevaluation of the suitability of this antioxidant for products prepared for intrathecal use.
据报道，在推测意外蛛网膜下腔注射用于硬膜外阻滞的2-氯普鲁卡因-CE（耐乐品-CE；N-CE）后，患者出现了慢性神经功能缺损。本研究调查了耐乐品-CE的两种成分——纯2-氯普鲁卡因（2-CP）和亚硫酸氢钠，在分别注射到神经功能完好的清醒家兔腰蛛网膜下腔时导致这些并发症的可能作用。在乳酸林格氏液中重复给予2-4毫克脊髓麻醉剂量的纯2-CP，即使累积剂量达到50毫克，也未产生慢性后肢麻痹。然而，1.2-2.4毫克亚硫酸氢钠（添加到N-CE中以延长保质期的抗氧化剂）导致14只动物中的12只出现不可逆的后肢麻痹。12-24毫克2%的N-CE中含有该剂量的亚硫酸氢钠。商业可用的2-CP中低剂量亚硫酸氢钠导致持续性麻痹的证明，需要重新评估这种抗氧化剂用于鞘内注射制剂的适用性。
