Gallo F, Alberti A, Fongaro A, Negri M G, Carlot A, Altafini L, Valenti S
Ospedale di Dolo, Dolo, Venezia.
Minerva Anestesiol. 1996 Jan-Feb;62(1-2):9-15.
To compare the quality of anesthesia produced by the intrathecal administration of equivalent doses of 0.5% and 1% hyperbaric bupivacaine in patients undergoing cesarian section.
A prospective, comparative and randomised clinical study.
Anesthesia Unit-Non-university civil hospital.
50 patients undergoing elective or emergency cesarian section randomly assigned to two groups of 25 patients each.
After prehydration, subarachnoid access was achieved through space L2-L3 or L3-L4 using a 24G Sprotte's needle with patients in right hand lateral decubitus. Patients in group A were injected with 1.25 ml of 1% hyperbaric bupivacaine and those in group B with 2.5 ml of 0.5% hyperbaric bupivacaine (12.5 mg). Patients were positioned immediately in partial decubitus on their left hand sides and ephedrine infusion, or if required i.v. bolus, was commenced to counter hypotension (SAP < 80% basal).
ECG, pulse measurement, arterial pressure with non-invasive method, metameric level of analgesia (pin prick), motor block of lower limbs (Bromage's scale), time lapsed between induction of anesthesia and extraction of neonate, Apgar score, quantity of ephedrine used, duration of surgery, respiratory complications, insufficient analgesia, resolution of motor block, any postspinal cephalea.
Variance analysis, Student's t-test, chi 2.
Both solutions guaranteed satisfactory intraoperative analgesia in 96% of cases. No statistically significant differences were noted between the two groups relating to the maximum duration of analgesia, the extent of motor block, induction times and regression, incidence of complications.
No important difference was observed in the quality of the anesthesia obtained using the intrathecal administration of equivalent doses of 1% and 0.5% solutions of hyperbaric bupivacaine in patients undergoing cesarian section. In view of the possible relationship between the neurotoxicity of local anesthetics and the concentration of the solution used for spinal anesthesia, it is to be hoped that less concentrated solutions of hyperbaric bupivacaine will be introduced in Italy compared to the 1% solution currently available.
比较剖宫产患者鞘内注射等效剂量的0.5%和1%高压布比卡因所产生的麻醉效果。
一项前瞻性、对比性随机临床研究。
非大学附属医院麻醉科。
50例行择期或急诊剖宫产的患者，随机分为两组，每组25例。
预充液后，患者取右侧卧位，使用24G Sprotte针经L2-L3或L3-L4间隙行蛛网膜下腔穿刺。A组患者注射1.25 ml 1%高压布比卡因，B组患者注射2.5 ml 0.5%高压布比卡因（12.5 mg）。患者立即改为左侧半卧位，开始静脉输注麻黄碱，必要时静脉推注，以对抗低血压（收缩压<基础值的80%）。
心电图、脉搏测量、无创动脉压、节段性镇痛平面（针刺）、下肢运动阻滞（Bromage评分）、麻醉诱导至新生儿娩出的时间、阿氏评分、麻黄碱用量、手术时间、呼吸并发症、镇痛不全、运动阻滞消退情况、任何脊髓穿刺后头痛。
方差分析、Student's t检验、卡方检验。
两种溶液在96%的病例中均保证了满意的术中镇痛效果。两组在最大镇痛持续时间、运动阻滞程度、诱导时间和恢复时间、并发症发生率方面均未观察到统计学显著差异。
在剖宫产患者中，鞘内注射等效剂量的1%和0.5%高压布比卡因溶液所获得的麻醉质量未观察到重要差异。鉴于局部麻醉药的神经毒性与用于脊髓麻醉的溶液浓度之间可能存在的关系，希望意大利引入比目前可用的1%溶液浓度更低的高压布比卡因溶液。
