Harti A, Mjahed K, Chlihi A, Lamine A, Laraki M, Barrou L, Ait Bahou K, Benaguida M
Service d'Anesthésie-Réanimation, CH Ibn Rochd, Casablanca, Maroc.
Cah Anesthesiol. 1993;41(3):217-20.
The prevention of blood pressure fall during a conventional spinal anaesthesia effected with 20 mg (4 ml) of isobaric 0.5 p. 100 bupivacaine relies on the use of vascular filling and/or a vasoconstrictor. A randomized prospective study was performed to evaluate the comparative efficacy of these two treatments. 148 patients were included and divided into three groups. Group I (n = 50): 2.5 mg IV bolus of etilefrine followed by continuous infusion (0.35 mg.kg-1.h-1). Group II (n = 50): 30 ml.kg-1 infusion of saline isotonic solution for 90 min, with infusion rate according to blood pressure. Group III (n = 48) did not receive any preventive treatment. A blood pressure fall of more than 30% of the initial value was observed in 59 patients: 18% of the etilefrine group, 28% of the saline infusion group, 54% of the control group. This peculiar frequency of hypotension in the control group emphasizes the need of a preventive treatment. Haemodynamic changes were fewer and less important in the etilefrine group compared with the saline infusion group. No failure and a better tolerance in the vasoconstrictor group were also to be noticed. These clinical data suggest that etilefrine could meet satisfactorily the therapeutic requirements.
在使用20毫克（4毫升）等比重0.5%布比卡因进行传统脊髓麻醉期间预防血压下降依赖于使用血管充盈剂和/或血管收缩剂。进行了一项随机前瞻性研究以评估这两种治疗方法的相对疗效。纳入148例患者并分为三组。第一组（n = 50）：静脉推注2.5毫克依替福林，随后持续输注（0.35毫克·千克⁻¹·小时⁻¹）。第二组（n = 50）：以每千克体重30毫升的速度输注等渗盐溶液90分钟，输注速度根据血压调整。第三组（n = 48）未接受任何预防性治疗。59例患者出现血压下降超过初始值的30%：依替福林组为18%，盐水输注组为28%，对照组为54%。对照组中这种特殊的低血压发生率强调了预防性治疗的必要性。与盐水输注组相比，依替福林组的血流动力学变化更少且程度更轻。还应注意到血管收缩剂组无失败病例且耐受性更好。这些临床数据表明依替福林可以令人满意地满足治疗需求。
