The effect of varied doses of epinephrine on duration of lidocaine spinal anesthesia in the thoracic and lumbosacral dermatomes
The effect of varied doses of epinephrine on duration of lidocaine spinal anesthesia in the thoracic and lumbosacral dermatomes
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DOI：
10.1097/00000539-199805000-00021
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发表时间：
1998-05-01
影响因子：
5.7
通讯作者：
Mori, K
中科院分区：
文献类型：
--
作者：
Kito, K;Kato, H;Mori, K
肾上腺素在延长脊髓镇痛中的有效性最近在腰骶段得到证实，但在胸段没有。大多数先前的研究使用小于0.3 mg的肾上腺素剂量。我们研究了0.2、0.4或0.6 mg肾上腺素加入60 mg高压利多卡因7.5%葡萄糖溶液中用于脊髓麻醉的效果。将80例患者随机分为4组：A组单纯使用利多卡因，B组在利多卡因基础上加用0.2 mg肾上腺素1：1000溶液，C组在利多卡因基础上加用0.4 mg肾上腺素，D组在利多卡因基础上加用0.6 mg肾上腺素。所有组的最大头侧感觉水平均在T2和T3之间。与A组相比，D组镇痛消退2个和4个节段的中位时间显著延长，但B或C组均未延长。与A组相比，B、C和D组回归至T12和L3的时间显著延长。我们得出结论，脊髓镇痛的剂量依赖关系可以应用于肾上腺素，并且较大剂量延长利多卡因脊髓麻醉在胸部以及腰骶部皮节。含义：鞘内注射肾上腺素可延长腰骶部的利多卡因脊髓镇痛作用，但在胸部皮节中则无此作用。比较了三种剂量的肾上腺素（0.2、0.4和0.6毫克）。证实了0.6 mg剂量在胸部皮节中的剂量依赖性反应和显著延长。
The efficacy of epinephrine in prolonging spinal analgesia has recently been confirmed in the lumbosacral but not in the thoracic, segments. Most previous studies used doses of epinephrine smaller than 0.3 mg. We studied the effects of 0.2, 0.4, or 0.6 mg of epinephrine added to hyperbaric Lidocaine 60 mg in 7.5% dextrose solution for spinal anesthesia. Eighty patients were randomly divided into four groups: Group A received lidocaine without epinephrine, Group B received Lidocaine plus 0.2 mt (0.2 mg) of epinephrine 1:1000 solution, Group C received Lidocaine plus 0.4 mi, (0.4 mg) of epinephrine, and Group D received Lidocaine plus 0.6 mt (0.6 mg) of epinephrine. The maximal cephalad sensory level was between T2 and T3 for all groups. The median times for analgesia to regress two and four segments were significantly prolonged in Group D, but not in either Group B or C, compared with those in Group A. Times for regression to T12 and L3 were significantly prolonged in Groups B, C, and D compared with Group A. We conclude that the dose-dependent relationship of spinal analgesia can be applied to epinephrine, and that larger doses prolong Lidocaine spinal anesthesia in the thoracic as well as the lumbosacral dermatomes. Implications: Prolongation of lidocaine spinal analgesia by intrathecal epinephrine is established in the lumbosacral, but not in the thoracic, dermatomes. Three doses of epinephrine-0.2, 0.4, and 0.6 mg-were compared. A dose-dependent response and significant prolongation with the 0.6-mg dose in the thoracic dermatomes were confirmed.