Salmela L, Aromaa U
Department of Anesthesia, Helsinki University Central Hospital, Finland.
Acta Anaesthesiol Scand. 1998 Aug;42(7):765-9. doi: 10.1111/j.1399-6576.1998.tb05319.x.
Transient radicular irritation (TRI) is common after spinal anesthesia induced with hyperbaric lidocaine 50 mg/ml. The purpose of this study was to determine the incidence of TRI after spinal anesthesia with hyperbaric lidocaine 50 mg/ml diluted with cerebrospinal fluid (CSF) 1:1 and hyperbaric mepivacaine 40 mg/ml and hyperbaric bupivacaine 5 mg/ml.
Ninety ASA class I-IV patients undergoing mostly brief urological procedures under spinal anesthesia were randomly allocated to receive either hyperbaric lidocaine 50 mg/ml diluted with CSF 1:1 (Group L), hyperbaric mepivacaine 40 mg/ml (Group M) or hyperbaric bupivacaine 5 mg/ml (Group B). Characteristics of the patients and details of the surgical procedures and spinal anesthesias were similar in all groups except for the intensity of motor block. The patients were evaluated on the first postoperative day by an anesthesiologist who did not know which spinal anesthetic agent had been used.
Six patients (20%) in group L, 11 patients (37%) in Group M and none (0%) in Group B experienced pain in the legs and/or back (TRI) after spinal anesthesia.
TRI is frequent after spinal anesthesia induced with hyperbaric lidocaine 50 mg/ml diluted with CSF 1:1. The incidence of TRI after hyperbaric mepivacaine 40 mg/ml is of the same magnitude. TRI could not be observed after bupivacaine spinal anesthesia.
使用50mg/ml的高压利多卡因诱导脊髓麻醉后，短暂性神经根刺激（TRI）很常见。本研究的目的是确定用脑脊液（CSF）1:1稀释的50mg/ml高压利多卡因、40mg/ml高压甲哌卡因和5mg/ml高压布比卡因进行脊髓麻醉后TRI的发生率。
90例主要在脊髓麻醉下进行简短泌尿外科手术的ASA I-IV级患者被随机分配接受用CSF 1:1稀释的50mg/ml高压利多卡因（L组）、40mg/ml高压甲哌卡因（M组）或5mg/ml高压布比卡因（B组）。除运动阻滞强度外，所有组患者的特征、手术过程和脊髓麻醉细节相似。术后第一天由一名不知道使用了哪种脊髓麻醉剂的麻醉医生对患者进行评估。
L组6例患者（20%）、M组11例患者（37%）在脊髓麻醉后出现腿部和/或背部疼痛（TRI），B组无一例（0%）出现。
用CSF 1:1稀释的50mg/ml高压利多卡因诱导脊髓麻醉后TRI很常见。40mg/ml高压甲哌卡因后TRI的发生率与之相当。布比卡因脊髓麻醉后未观察到TRI。
