麻醉液容量對以Tetracaine作等比重脊髓麻醉的影響

EFFECT OF DRUG VOLUME ON SPINAL ANESTHESIA WITH ISOBARIC TETRACAINE

金華高(Kwa-Kou King)；王隆豐(Long-Fong Wang)

Tetracaine ； Spinal anesthesia

Acta Anaesthesiologica Sinica

28卷3期（1990 / 09 / 01）

337 - 341

繁體中文

本文是一系列脊髓麻醉研究之一部份。乃於100位年齡自14歲至85歲的患者，以單純隨機取樣法分成二組，分別浸1mL或2mL。內含Tetracaine 10mg之等比重應作等劑量而不同重量之脊髓麻醉研究。本系列脊髓麻醉研究之實施細則基本類同，每次集中研究一個變數，其他務求一致便於比較分析。所獲資料分析結果為：1）感覺阻斷最高脊位所需之時間，第一組7.18±1.85分鐘；第二組5.18±1.85分鐘，其差別為2分鐘，具統計學意義；2）第一組之最高皮節中位值（median）為T_7而第二組則為T_（10），其差別也具統計學意義；3）二皮節減退時間分別為180±53.44分鐘及219±34.11分鐘，第二組者較長約40分鐘：4）運動遮斷之程度和時間，以Modified BromapeScale計值，第一組中有15位患者僅達者二夜遮斷而第二組則全部都獲得第三度遮斷具統計學意義，唯具所需時間則分別為5.45±1.59及5.98±1.79分鐘，不具統計學意義。

The effect s of drug volume on spinal anesthesia with 10 mg tetracaine in 1 ml or 2 ml isobaric solution were studied in 100 demographically compatible patient s in a randomized double-blind manner. Identical technqiue was used for every patient in the study except for the volume of anesthetic solutions. Drugs were administered in a lateral decubitus position and patients remained horizontal during the study. Hoghest cephalad spread of analgesia varied from T12-T3, with a median sensory level of D inthose who received 2 ml solutions, compared with T12-T5 and a median level o f T10 in those who received 1 ml solutions. The time for maximum spread was longer in 2 ml - group (7.5 4±1.76 min vs 4 .85±1.54 min). The 2-segment regression times were 180 ±53.44 min (mean) with a range of 75 -270 min, and 219±34.11 min (mean) with a range of 150 -300 min respectively for the 2 ml - group and the 1 min group. The differences were statistically significant. Complete motor blockade of the lower extremities as assessed by the modified Bromage scale was achieved in 35 out of 50 patients given 2 ml solutions, while all those who received I ml solutions achieved complete motor blockade. The onset times of maximum blockade were 5.42±1.59 min (mean) with a range of 2-10 min, and 5.98±1.79 min (mean) with a range o f 2-12 min respectively. The difference between the degree of maximum motor blockade was also statistically significant but was insignificant regarding the time to maximum motor blockade. The authors therefore concluded that in tetracine isobaric spinal anesthesia, employing a smaller volume resulted in significantly lower sensory levels and longer duration; and it may provide a better motor blockade than a larger volume of the smae dosage.