Gentili M, Senlis H, Houssel P, Monnier B, Bonnet F
Clinique Saint Vincent, Saint Grégoire, France.
Reg Anesth. 1997 Nov-Dec;22(6):511-4.
The potential risks of spinal lidocaine have generated interest in an alternative local anesthetic solution. Features of anesthetic block were therefore assessed in a double-blind randomized prospective study following administration of spinal bupivacaine in small doses.
Ninety patients scheduled for lower limb saphenous vein stripping were randomized to receive a 4-mL hyperbaric solution containing 4, 6, or 8 mg bupivacaine in the subarachnoid space. Sensory and motor block and hemodynamic changes were assessed at regular intervals. Patients were also questioned regarding transient radicular irritation symptoms.
The mean duration of sensory block increased with increasing dose (duration at L2: 56 +/- 27, 71 +/- 29, 79 +/- 25 minutes in groups 4, 6, and 8 mg, respectively, P < .05). Motor block was also dose dependent. The incidence of grade 3 motor block increased from 0%, to 21%, and to 53%. No patient had symptoms of transient radicular irritation. Arterial pressure and heart rate were stable throughout the study.
Hyperbaric bupivacaine 6-8 mg provides a suitable alternative to spinal lidocaine for surgical procedures of short duration.
脊髓利多卡因的潜在风险引发了人们对另一种局部麻醉解决方案的兴趣。因此，在一项双盲随机前瞻性研究中，对小剂量蛛网膜下腔注射布比卡因后的麻醉阻滞特征进行了评估。
将90例计划行下肢大隐静脉剥脱术的患者随机分为三组，分别在蛛网膜下腔接受含4、6或8mg布比卡因的4ml重比重溶液。定期评估感觉和运动阻滞以及血流动力学变化。还询问患者是否有短暂性神经根刺激症状。
感觉阻滞的平均持续时间随剂量增加而延长（L2节段的持续时间：4mg组、6mg组和8mg组分别为56±27、71±29和79±25分钟，P<.05）。运动阻滞也呈剂量依赖性。3级运动阻滞的发生率从0%增加到21%，再到53%。没有患者出现短暂性神经根刺激症状。在整个研究过程中，动脉压和心率保持稳定。
6-8mg重比重布比卡因可为短期手术提供一种合适的脊髓利多卡因替代方案。
