Hetherington R, Stevens R A, White J L, Spitzer L, Koppel S
Department of Anesthesiology, Georgetown University School of Medicine, Washington, D.C.
Reg Anesth. 1994 Jul-Aug;19(4):284-8.
This study reports subjective experiences of nine anesthesiologists undergoing three consecutive epidural anesthetics.
Eight anesthesiologists and one nurse anesthetist, all ASA physical status 1, underwent three lumbar epidural anesthetics as part of another study. Epidural catheters were inserted via a 17-gauge Tuohy needle without sedation after local anesthesia with pH adjusted lidocaine at the second, third, or fourth lumbar interspace. Three local anesthetics (2% lidocaine HCl, 3% chloroprocaine HCl, and 0.75% bupivacaine HCl) were administered each separated by at least 48 hours. The local anesthetic was incrementally injected via the epidural catheter to achieve at least a T-1 dermatome level of analgesia. Each subject completed a written questionnaire at the end of the study regarding their experience.
Most of the subjects (7 of 9) had no prior epidural anesthesia. Eight of nine subjects experienced at least one paresthesia during catheter insertion; this was uniformly described as a "poorly localized burning sensation," radiating to the hip or leg. All subjects reported difficulty taking a deep breath and coughing with a T-1 level of analgesia. Eight of nine subjects reported dysphoria during lidocaine epidural anesthesia. Eight of nine subjects reported moderate back pain after dissipation of chloroprocaine epidural anesthesia.
All volunteers stated that they would change their anesthetic practice as a result of participation in this study. They believed that having experienced an epidural anesthetic made them better qualified to prepare patients for this anesthetic technique.
本研究报告了九名麻醉医生连续接受三次硬膜外麻醉的主观体验。
八名麻醉医生和一名麻醉护士，均为ASA身体状况1级，作为另一项研究的一部分接受了三次腰椎硬膜外麻醉。在第二、第三或第四腰椎间隙用pH值调整的利多卡因局部麻醉后，通过17号Tuohy针在无镇静的情况下插入硬膜外导管。三种局部麻醉药（2%盐酸利多卡因、3%盐酸氯普鲁卡因和0.75%盐酸布比卡因）分别给药，每次间隔至少48小时。通过硬膜外导管逐渐注入局部麻醉药，以达到至少T-1皮节水平的镇痛效果。每位受试者在研究结束时填写了一份关于其体验的书面问卷。
大多数受试者（9名中的7名）此前未接受过硬膜外麻醉。9名受试者中有8名在导管插入过程中至少经历了一次感觉异常；均被描述为“定位不佳的烧灼感”，放射至臀部或腿部。所有受试者均报告在T-1镇痛水平时深呼吸和咳嗽困难。9名受试者中有8名报告在利多卡因硬膜外麻醉期间出现烦躁不安。9名受试者中有8名报告在氯普鲁卡因硬膜外麻醉消散后出现中度背痛。
所有志愿者均表示，由于参与本研究，他们会改变自己的麻醉操作方式。他们认为，经历过硬膜外麻醉使他们更有资格为患者准备这种麻醉技术。
