Martin R, Martin G, Martin D, Vallet P, Jean M, Tétrault J P
Département d'anesthésie-réanimation, Université de Sherbrooke, Province de Québec, Canada.
Ann Fr Anesth Reanim. 1997;16(5):479-82. doi: 10.1016/s0750-7658(97)83340-0.
To compare lidocaine hydrocarbonate and lidocaine hydrochloride, with and without adrenaline, in the axillary block obtained with a neurostimulator.
Prospective, randomized, double blind study.
Sixty-six patients undergoing surgery of the upper limb under axillary block, allocated into four groups.
The criteria for evaluation were: onset time, duration and quality of sensory and motor blockades, and blood concentrations of lidocaine in 39 patients. In all patients musculocutaneous, radial, median and ulnar nerves were stimulated and the volume of local anaesthetic administered was 25 mL per square meter of body surface. Group 1 received lidocaine hydrocarbonate 1% (n = 17), group 2, lidocaine hydrocarbonate 1% with adrenaline 1/200,000 (n = 17), group 3, lidocaine hydrochloride 1% (n = 16) and group 4, lidocaine hydrochloride 1% with adrenaline 1/200,000 (n = 16).
No significant inter-group differences were found concerning sensory and motor blockades and onset time. The duration of analgesia was longer in groups CO2 + A and HCL + A. The lidocaine blood concentrations were globally lower in group HCL + A.
Considering the cost/benefit ratio and the absence of clinical benefits of lidocaine hydrocarbonate, lidocaine hydrochloride should be preferred.
比较在神经刺激器辅助下进行腋路阻滞时，碳酸利多卡因与盐酸利多卡因，以及加用和未加用肾上腺素的情况。
前瞻性、随机、双盲研究。
66例接受上肢手术并在腋路阻滞下进行的患者，分为四组。
评估标准为：39例患者的感觉和运动阻滞的起效时间、持续时间及质量，以及利多卡因的血药浓度。对所有患者的肌皮神经、桡神经、正中神经和尺神经进行刺激，每平方米体表面积给予局部麻醉药25 mL。第1组接受1%碳酸利多卡因（n = 17），第2组接受1%碳酸利多卡因加1/200,000肾上腺素（n = 17），第3组接受1%盐酸利多卡因（n = 16），第4组接受1%盐酸利多卡因加1/200,000肾上腺素（n = 16）。
在感觉和运动阻滞及起效时间方面，未发现组间有显著差异。CO2 + A组和HCL + A组的镇痛持续时间更长。HCL + A组的利多卡因血药浓度总体较低。
考虑到成本效益比以及碳酸利多卡因缺乏临床益处，应优先选择盐酸利多卡因。
