James F M, Dewan D M, Floyd H M, Wheeler A S, Grant W M, Rhyne L, Westmoreland R T
Anesthesiology. 1980 Jun;52(6):488-91. doi: 10.1097/00000542-198006000-00006.
The incidence and degree of hypotension, time to establish surgical analgesia, and several other maternal and fetal variables were studied when 2-chloroprocaine, 3 per cent, and bupivacaine, 0.5 per cent, were used for epidural analgesia in 30 women undergoing elective cesarean section. Surgical analgesia occurred 8 min sooner (P less than 0.001) with chloroprocaine (14 +/- 1 min) than with bupivacaine (22 +/- 2 min). Blood pressure values were significantly lower with chloroprocaine than with bupivacaine during the 18--to-32 min interval after local anesthetic injection, while pulse rates were higher (P less than 0.05) at 18, 20, and 22 min. Hypotension necessitating treatment with ephedrine occurred in 33 per cent of chloroprocaine-treated subjects, compared with 13 per cent of those receiving bupivacaine. Newborn outcome was excellent in both groups, as reflected by umbilical vessel blood-gas values, times to sustained respiration, and 5-min Apgar scores. The authors conclude that chloroprocaine disturbs maternal cardiovascular status more than does bupivacaine when used for cesarean section epidural analgesia. However, chloroprocaine can be employed safely in normal pregnancies if maternal hypotension is corrected rapidly.
对30例行择期剖宫产的产妇，分别使用3%的2 - 氯普鲁卡因和0.5%的布比卡因进行硬膜外镇痛，研究了低血压的发生率和程度、建立手术镇痛的时间以及其他一些母婴变量。使用氯普鲁卡因（14±1分钟）时手术镇痛出现的时间比布比卡因（22±2分钟）早8分钟（P<0.001）。在局部麻醉药注射后18至32分钟内，氯普鲁卡因组的血压值显著低于布比卡因组，而在18、20和22分钟时心率较高（P<0.05）。33%接受氯普鲁卡因治疗的产妇出现需要麻黄碱治疗的低血压，而接受布比卡因治疗的产妇这一比例为13%。从脐血管血气值、持续呼吸时间和5分钟阿氏评分来看，两组新生儿结局均良好。作者得出结论，在剖宫产硬膜外镇痛中，氯普鲁卡因比布比卡因更易扰乱产妇心血管状态。然而，如果能迅速纠正产妇低血压，氯普鲁卡因可安全用于正常妊娠。
