用重比重布比卡因进行单侧脊髓麻醉。

Unilateral spinal anaesthesia with hyperbaric bupivacaine.

作者信息

Esmaoğlu A, Boyaci A, Ersoy O, Güler G, Talo R, Tercan E

机构信息

Department of Anesthesiology, University Hospital of Erciyes, Kayseri, Turkey.

出版信息

Acta Anaesthesiol Scand. 1998 Oct;42(9):1083-7. doi: 10.1111/j.1399-6576.1998.tb05380.x.

DOI:10.1111/j.1399-6576.1998.tb05380.x

PMID:9809092

Abstract

BACKGROUND

The dosage of local anaesthetic and the time the patient must be kept in the lateral decubitus position for a unilateral spinal anaesthesia is not known. The aim of this study was to determine the ideal dosage of hyperbaric bupivacaine and the time required for the lateral decubitus position for a unilateral spinal block.

METHODS

Ninety patients who were scheduled to receive spinal block for surgery in the lower extremity were randomised into 9 groups (n = 10). The spinal block was performed through the L4-L5 intervertebral space with the patient in the lateral decubitus position. Patients in groups Ia, Ib, Ic; IIa, IIb, IIc; IIIa, IIIb, IIIc received 1.5 ml of 0.5%, 2 ml of 0.5%, and 2.5 ml of 0.5% hyperbaric bupivacaine solutions, respectively. The patients were turned to the supine position for 5 min after the injection in groups Ia, IIa, IIIa, 10 min after the injection in groups Ib, IIb, IIIb, and 15 min after the injection in groups Ic, IIc, IIIc. The onset and regression of sensory and motor block were checked and compared between the dependent and non-dependent sides in each group.

RESULTS

The rate of block progression of the non-dependent side was higher in the groups receiving 2.5 ml 0.5% hyperbaric bupivacaine solution than in the other groups; at the same time the level of block was higher and the duration of block was longer. The incidence of hypotension was 10-20% in these groups. In the 2 ml 0.5% hyperbaric bupivacaine solution groups, a satisfactory block level and duration of anaesthesia for surgery was obtained. The rate of block progression to non-dependent side in the groups receiving 1.5 ml of 0.5% hyperbaric bupivacaine solution was lower than the other groups, but the duration of block was shorter and the level of block was lower than the other groups.

CONCLUSION

For unilateral spinal anaesthesia in lower extremity operations, 2ml 0.5% hyperbaric bupivacaine solution for operations above the knee and 1.5 ml 0.5% hyperbaric bupivacaine solution for operations below the knee and keeping the patients for 10 min in the lateral decubitus position were found to be appropriate.

摘要

背景

单侧脊髓麻醉时局部麻醉药的剂量以及患者必须保持侧卧位的时间尚不清楚。本研究的目的是确定高压布比卡因的理想剂量以及单侧脊髓阻滞所需的侧卧位时间。

方法

将90例计划接受下肢手术脊髓阻滞的患者随机分为9组（每组n = 10）。患者取侧卧位，通过L4-L5椎间隙进行脊髓阻滞。Ia、Ib、Ic组；IIa、IIb、IIc组；IIIa、IIIb、IIIc组患者分别接受1.5 ml 0.5%、2 ml 0.5%和2.5 ml 0.5%的高压布比卡因溶液。Ia、IIa、IIIa组注射后让患者仰卧5分钟，Ib、IIb、IIIb组注射后仰卧10分钟，Ic、IIc、IIIc组注射后仰卧15分钟。检查并比较每组中患侧和非患侧感觉和运动阻滞的起效和消退情况。

结果

接受2.5 ml 0.5%高压布比卡因溶液的组中非患侧的阻滞进展率高于其他组；同时阻滞平面更高，阻滞持续时间更长。这些组中低血压的发生率为10%-20%。在2 ml 0.5%高压布比卡因溶液组中，获得了满意的手术麻醉阻滞平面和持续时间。接受1.5 ml 0.5%高压布比卡因溶液的组中非患侧的阻滞进展率低于其他组，但阻滞持续时间较短，阻滞平面低于其他组。