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Spinal anesthesia using hyperbaric bupivacaine HCl for cesarean section

机译：盐酸布比卡因高压麻醉进行剖宫产术中的脊髓麻醉

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BACKGROUND: We performed this prospective study to determine the proper amount of hyperbaric bupivacaine hydrochloride as a spinal anesthetic agent for cesarean section. METHODS: The parturients were randomly allocated to receive one of four spinal agents in a blind manner; tetracaine 10 mg (control), bupivacaine 10, 12.5 and 15 mg. Morphine HCl 0.1 mg was added to each agent and the total volume was adjusted to 3.1 ml with 10% glucose solution. RESULTS: All the four spinal agents provided an adequate analgesic level (T 5) without serious complications. Among the three dosages of bupivacaine, the time interval requiring for anesthetic level to reach T 5 tended to be shorter with a larger amount of bupivacaine. The incidence of intraoperative supplemental analgesic and hypotension and the dosage of ephedrine used to treat hypotension were greater in the patients anesthetized with tetracaine 10 mg than in those anesthetized with bupivacaine 10 mg, which is equipotent to tetracaine 10 mg. CONCLUSIONS: 1. As a spinal anesthetic agent for cesarean section, hyperbaric bupivacaine is superior to tetracaine. 2. Hyperbaric bupivacaine 10 mg, 12.5 mg or 15 mg can be used safely and effectively as a spinal agent for cesarean section. 3. High dose bupivacaine is recommended in an urgent case, and low dose bupivacaine is recommended when maternal hypotension must be strictly avoided.
机译：背景：我们进行了这项前瞻性研究，以确定适当的高压布比卡因盐酸盐作为剖宫产术中的脊柱麻醉剂。方法：产妇被随机分配，以盲人方式接受四种脊椎药物之一;丁卡因10毫克（对照），布比卡因10、12.5和15毫克。向每种试剂中添加0.1 mg盐酸吗啡，并用10％葡萄糖溶液将总体积调节至3.1 ml。结果：所有四种脊柱药物均提供了足够的镇痛水平（T 5），而没有严重的并发症。在布比卡因的三种剂量中，麻醉剂量达到T 5所需的时间间隔往往随着布比卡因的量的增加而缩短。在用丁卡因10 mg麻醉的患者中，术中补充镇痛药和低血压的发生率以及用于治疗低血压的麻黄碱的剂量要大于用布比卡因10 mg麻醉的患者，后者与丁卡因10 mg等效。结论：1.高压布比卡因作为剖宫产术中的脊柱麻醉剂优于丁卡因。 2.高压布比卡因10 mg，12.5 mg或15 mg可安全有效地用作剖宫产术的脊柱药物。 3.在紧急情况下，建议使用大剂量布比卡因;当必须严格避免产妇低血压时，建议使用小剂量布比卡因。

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