Koscielniak-Nielsen Z J, Horn A
Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Denmark.
Anaesthesia. 1993 Sep;48(9):769-72. doi: 10.1111/j.1365-2044.1993.tb07587.x.
Twenty-six adult patients participated in this study of intra-arterial and intravenous regional analgesia. The radial or the brachial artery was cannulated in patients randomised to receive intra-arterial regional analgesia and a hand vein was cannulated in patients randomised to receive intravenous regional analgesia, with a 22-G cannula. A double cuffed tourniquet and Esmarch's bandage were used. Lignocaine 0.5%, (1.5 mg.kg-1 intra-arterially, and 3.0 mg.kg-1 intravenously) was injected over 3 min. There were two failures (one in each group). Intra-arterial injection of lignocaine was more painful than intravenous injection. Onset and offset of analgesia, surgical and tourniquet pain scores, motor blockade, and bruising after cannulations were similar. Surgical conditions were good in all patients having intra-arterial regional analgesia, fair and poor in five having intravenous regional analgesia (ns). Three of the intravenous regional analgesia patients had transient adverse affects after tourniquet release (ns). No permanent sequelae of cannulations were observed. It is concluded that intra-arterial regional analgesia with lignocaine 0.5%, 1.5 mg.kg-1 has similar onset, offset, quality, failure rate and patient acceptance, as intravenous regional analgesia with lignocaine 0.5%, 3.0 mg.kg-1.
26名成年患者参与了这项关于动脉内和静脉区域镇痛的研究。随机接受动脉内区域镇痛的患者，通过22G套管针穿刺桡动脉或肱动脉；随机接受静脉区域镇痛的患者，穿刺手部静脉。使用双袖带止血带和埃斯马赫绷带。静脉注射0.5%利多卡因（动脉内注射剂量为1.5mg/kg，静脉内注射剂量为3.0mg/kg），注射时间为3分钟。有两例失败（每组各1例）。动脉内注射利多卡因比静脉内注射更疼。镇痛的起效和消退、手术和止血带疼痛评分、运动阻滞以及穿刺后的瘀斑情况相似。所有接受动脉内区域镇痛的患者手术条件良好，5例接受静脉区域镇痛的患者手术条件为中等或较差（无显著性差异）。3例接受静脉区域镇痛的患者在止血带松开后出现短暂不良反应（无显著性差异）。未观察到穿刺的永久性后遗症。结论是，0.5%利多卡因、1.5mg/kg的动脉内区域镇痛与0.5%利多卡因、3.0mg/kg的静脉区域镇痛在起效、消退、质量、失败率和患者接受度方面相似。
