Datta S, Corke B C, Alper M H, Brown W U, Ostheimer G W, Weiss J B
Anesthesiology. 1980 Jan;52(1):48-51. doi: 10.1097/00000542-198001000-00010.
The authors studied three groups of patients undergoing elective cesarean section during lumbar epidural anesthesia with bupivacaine, 0.75 per cent (15 patients), chloroprocaine, 3 per cent (15 patients) or etidocaine, 1 per cent (ten patients). Excellent sensory and motor block were obtained with chloroprocaine and bupivacaine; sensory anesthesia was inadequate with etidocaine in most patients. Onset of anesthesia, induction--delivery interval, and stay in the recovery room were all longer with bupivacaine when compared with chloroprocaine. Fetal outcomes, as determined by Apgar scores, acid--base status and neurobehavioral testing, were equally good in all groups. At delivery, fetal/maternal concentration ratio of bupivacaine was 0.31 and that of etidocaine, 0.25. The umbilical artery--umbilical vein blood concentration difference for etidocaine was significantly higher than that for bupivacaine. Excellent clinical results were obtained using either bupivacaine, 0.75 per cent, alone, or chloroprocaine, 3 per cent- for induction and maintenance of anesthesia, supplemented with bupivacaine, 0.25 per cent, before removal of the catheter.
作者研究了三组在腰段硬膜外麻醉下接受择期剖宫产的患者，分别使用0.75%布比卡因（15例患者）、3%氯普鲁卡因（15例患者）或1%依替卡因（10例患者）。氯普鲁卡因和布比卡因均获得了良好的感觉和运动阻滞效果；大多数患者使用依替卡因时感觉麻醉效果欠佳。与氯普鲁卡因相比，布比卡因的麻醉起效时间、诱导至分娩间隔时间及在恢复室的停留时间均更长。通过阿氏评分、酸碱状态和神经行为测试确定的胎儿结局在所有组中均同样良好。分娩时，布比卡因的胎儿/母体浓度比为0.31，依替卡因的为0.25。依替卡因的脐动脉-脐静脉血浓度差显著高于布比卡因。单独使用0.75%布比卡因或3%氯普鲁卡因进行麻醉诱导和维持，并在拔除导管前补充0.25%布比卡因，均获得了良好的临床效果。
