Tsujiguchi N, Kohro S, Arakawa J, Omote T, Yamakage M, Namiki A
Department of Anesthesia, Asahikawa Red Cross Hospital.
Masui. 1998 Mar;47(3):318-21.
We investigated the effect of scalp infiltration with bupivacaine on blood coagulability and fibrinolysis in neurovascular surgery. Patients were randomly divided into two groups: scalp infiltration group (who received scalp infiltration with 0.5% bupivacaine prior to surgical incision, n = 7) and control group (n = 6). The blood coagulability and fibrinolysis were measured before and after surgical incision using a thromboelastogram (Thromboelastograph C-3000, Haemoscope). In the control group, the reaction and coagulation times were significantly shortened (30% and 23%, respectively, P < 0.05) and the maximum amplitude, which reflects coagulability, increased significantly (21%, P < 0.01) compared to each presurgical value. The scalp infiltration prior to the surgical incision prevented these reactions (P < 0.05). The fibrinolytic rate did not change in either group. We conclude that scalp infiltration prior to surgical incision is beneficial for attenuating an increase in blood coagulability, which could induce perioperative complications due to associated systemic diseases (i.e. hypertension, diabetes, ischemic heart disease, etc.).
我们研究了布比卡因头皮浸润对神经血管手术中血液凝固性和纤维蛋白溶解的影响。患者被随机分为两组：头皮浸润组（手术切口前接受0.5%布比卡因头皮浸润，n = 7）和对照组（n = 6）。使用血栓弹力图仪（血栓弹力图C - 3000，Hemoscope）在手术切口前后测量血液凝固性和纤维蛋白溶解。在对照组中，与每个术前值相比，反应时间和凝血时间显著缩短（分别为30%和23%，P < 0.05），反映凝固性的最大振幅显著增加（21%，P < 0.01）。手术切口前的头皮浸润可防止这些反应（P < 0.05）。两组的纤维蛋白溶解率均未改变。我们得出结论，手术切口前的头皮浸润有利于减轻血液凝固性增加，而这种增加可能因相关全身性疾病（即高血压、糖尿病、缺血性心脏病等）导致围手术期并发症。
