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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Epidural bolus injection with alkalinized lidocaine improves blockade of the first sacral segment - a brief report: (L'injection epidurale d'un bolus de lidocaine alcalinisee ameliore le blocage du premier segment sacre - un resume).
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Epidural bolus injection with alkalinized lidocaine improves blockade of the first sacral segment - a brief report: (L'injection epidurale d'un bolus de lidocaine alcalinisee ameliore le blocage du premier segment sacre - un resume).

机译：硬膜外推注碱化利多卡因可改善对第一个segment节的阻滞-简要报告：（在圣节第一节注射利多卡因的利多卡因推注硬膜外注射）。

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PURPOSE: It has been reported that the addition of epinephrine and/or bicarbonate to local anesthetic enhances the depth of epidural blockade and that initial partial bolus injection results in greater caudal spread. We evaluated the anesthetic effects of lidocaine with epinephrine and/or bicarbonate injected into the epidural space by bolus or catheter injection. METHODS: Forty-four patients undergoing epidural anesthesia with 17 mL of 2% lidocaine containing 1:200,000 epinephrine at L4-5 or L5-S1 were randomly divided into four groups. Lidocaine was administrated via epidural catheter [lidocaine catheter (LC) group] or Tuohy needle (lidocaine bolus group), lidocaine-bicarbonate was administrated via catheter (lidocaine-bicarbonate catheter group) or needle [lidocaine-bicarbonate bolus (LBB) group]. Pain threshold after repeated electrical stimulation was performed at L2 and S1 regions. Motor blockade was evaluated using the Bromage scale. Sympathetic blockade was assessed with plethysmographic waveforms from the toe. RESULTS: The pain threshold of the S1 dermatome in LBB group was significantly higher than in the lidocaine only groups, however, differences in the pain threshold at the L2 dermatome among the groups were insignificant. The onset of sensory blockade in the S1 dermatome in the LBB group was significantly shorter than in the LC group. Significantly greater motor blockade was achieved in the lidocaine-bicarbonate groups than in the lidocaine-only groups. The amplitude of plethysmographic waveforms significantly increased within each group. CONCLUSION: Epidural bolus injection of lidocaine-bicarbonate with epinephrine improves the pain threshold and speeds the onset of the blockade of the first sacral region.
机译：用途：据报道，在局部麻醉药中加入肾上腺素和/或碳酸氢盐可增强硬膜外阻滞的深度，最初的部分推注会导致更大的尾椎扩散。我们评估了通过推注或导管注射将利多卡因与肾上腺素和/或碳酸氢盐注射入硬膜外腔的麻醉效果。方法：44例接受硬膜外麻醉的患者在L4-5或L5-S1接受17 mL 2％利多卡因的麻醉，其中含1：200,000肾上腺素，随机分为四组。利多卡因通过硬膜外导管[利多卡因导管（LC）组]或Tuohy针（利多卡因推注组）给药，利多卡因-碳酸氢盐通过导管（利多卡因-碳酸氢盐导管组）或针头[利多卡因-碳酸氢盐推注（LBB）组）给药。在L2和S1区域进行重复电刺激后的疼痛阈值。使用Bromage量表评估运动阻滞。用足尖的容积描记波形评估交感神经阻滞。结果：LBB组中S1皮刀的疼痛阈值明显高于仅利多卡因组，但两组之间L2皮刀的疼痛阈值差异不显着。 LBB组中S1型皮肤刀的感觉阻滞发生时间明显短于LC组。与仅使用利多卡因的组相比，在利多卡因-碳酸氢盐组中实现了更大的运动阻滞。在每组中体积描记波形的幅度都显着增加。结论：硬膜外推注利多卡因-碳酸氢盐与肾上腺素可改善疼痛阈值，并加快第一region骨区域的阻滞发作。

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