Venuti F S, Curatolo M, Mandolfino T, Orlando A
Istituto Pluridisciplinare di Anestesia, Rianimazione e Terapia Intensiva, Università degli Studi di Messina.
Minerva Anestesiol. 1994 Apr;60(4):175-9.
To compare carbonated mepivacaine to carbonated lidocaine in epidural anaesthesia.
Nonrandomised control trial.
University Hospital.
Forty patients undergoing epidural anaesthesia for orthopaedic surgery.
Epidural anaesthesia at the fourth lumbar interspace, administering either carbonated mepivacaine 20 ml (group M, 20 patients) or carbonated lidocaine 20 ml (group L, 20 patients). Parameters recorded: onset of sensory block (time required to reach L1 and time required to reach the upper level), cranial spread of analgesia (number of dermatomes), duration of block (time between achievement of maximum spread of analgesia and regression of sensory block by two dermatomes) and motor block (Bromage score).
No statistically significant differences have been found between group M and group L in the time required to reach L1 (means and standard deviations 6.3 +/- 3.8 and 6.5 +/- 2.1 minutes, respectively), in the time required to reach the upper level of analgesia (means and standard deviations 14.3 +/- 4.2 and 16.5 +/- 3.5 minutes, respectively), in the cranial spread of analgesia (means and standard deviations 7.1 +/- 3.4 and 7.6 +/- 2.7 dermatomes, respectively) and in the degree of motor block (means and standard deviations 1.5 +/- 0.8 and 1.1 +/- 0.8, respectively). Group M exhibited a much higher duration of sensory block, compared to group L (means and standard deviations 91.6 +/- 20.2 and 58.8 +/- 23.4 minutes, respectively, p < 0.001).
Carbonated mepivacaine is more indicated than carbonated lidocaine in epidural anaesthesia when a high duration of sensory block is desired.
比较碳酸甲哌卡因与碳酸利多卡因用于硬膜外麻醉的效果。
非随机对照试验。
大学医院。
40例接受骨科手术硬膜外麻醉的患者。
于第四腰椎间隙行硬膜外麻醉，给予20毫升碳酸甲哌卡因（M组，20例患者）或20毫升碳酸利多卡因（L组，20例患者）。记录的参数包括：感觉阻滞起效时间（到达L1所需时间和到达上界所需时间）、镇痛的头端扩散范围（皮节数量）、阻滞持续时间（镇痛最大扩散范围达到至感觉阻滞消退两个皮节之间的时间）以及运动阻滞（布罗玛杰评分）。
M组和L组在到达L1所需时间（均值和标准差分别为6.3±3.8分钟和6.5±2.1分钟）、到达镇痛上界所需时间（均值和标准差分别为14.3±4.2分钟和16.5±3.5分钟）、镇痛的头端扩散范围（均值和标准差分别为7.1±3.4个皮节和7.6±2.7个皮节）以及运动阻滞程度（均值和标准差分别为1.5±0.8和1.1±0.8）方面均未发现统计学上的显著差异。与L组相比，M组的感觉阻滞持续时间长得多（均值和标准差分别为91.6±20.2分钟和58.8±23.4分钟，p<0.001）。
当需要较长时间的感觉阻滞时，在硬膜外麻醉中碳酸甲哌卡因比碳酸利多卡因更适用。
