Andersen S, Cold G E
Acta Anaesthesiol Scand. 1981 Jun;25(3):279-81. doi: 10.1111/j.1399-6576.1981.tb01651.x.
In 51 men, aged 60-87 years, subjected to lumbar epidural analgesia for transurethral resection of the prostate gland, the relationship between doses of 10, 15 and 20 ml mepivacaine 1.5 with adrenaline 1:200,000 and the extension of analgesia was studied. Three different postures during application of epidural analgesia were investigated (left lateral position, sitting position with the patient turned supine immediately after injection, and the sitting position with the patient turned supine 5 min after injection. The results indicate that posture did not significantly influence the extension of analgesia, which was found to be positively correlated to the volume of mepivacaine, and the segmental dose requirement was positively correlated to the volume injected. It is concluded that transurethral resection of the prostate gland in patients over 60 years old can be performed using mepivacaine 1.5% with adrenaline 1:200,000 injected in the lumbar epidural space. In some cases, doses of 15 and 20 ml provoked an unwanted extension of analgesia, reaching the upper thoracic segments.
对51名年龄在60至87岁之间、因经尿道前列腺切除术而接受腰段硬膜外镇痛的男性患者，研究了10毫升、15毫升和20毫升含1:200,000肾上腺素的1.5%甲哌卡因剂量与镇痛范围之间的关系。研究了硬膜外镇痛应用过程中的三种不同体位（左侧卧位、注射后立即转为仰卧位的坐位、注射后5分钟转为仰卧位的坐位）。结果表明，体位对镇痛范围无显著影响，镇痛范围与甲哌卡因体积呈正相关，节段剂量需求与注射体积呈正相关。结论是，60岁以上患者的经尿道前列腺切除术可通过在腰段硬膜外间隙注射含1:200,000肾上腺素的1.5%甲哌卡因来进行。在某些情况下，15毫升和20毫升的剂量会引起不必要的镇痛范围扩大，达到胸段上部。
