氯普鲁卡因用于蛛网膜下腔麻醉的临床观察

目的 观察国产氯普鲁卡因腰麻的临床效果。方法 40例患者经L3-4脊间隙行腰麻穿刺,向蛛网膜下间隙注入(针斜面向尾)氯普鲁卡因合剂(2.5%氯普鲁卡因1.2 ml+10%葡萄糖0.5 m l+3%麻黄碱0.5 ml)2.2ml/30~40秒。结果①麻醉起效时间、胸10无痛时间、双下肢不能抬起时间、达到最高阻滞平面的时间,分别为(21.69±9.43)sec、(3.56±0.77)min、(3.56±0.64)m in和(7.94±1.02)min;最高阻滞平面为胸5.03±1.27;麻醉消退至胸12开始疼痛时间、双下肢能抬起时间、麻醉完全消失时间,分别为(56.67±8.47)min、(67.94±12.85)m in和(76.95±17.17)min。②术中无患者诉疼痛。③麻醉后未出现低血压反应。心率相对稳定。SpO2正常。④麻醉后未出现恶心、呕吐。⑤麻醉后及其3天内未见任何精神神经系统不良反应。⑥2.5%氯普鲁卡因pH为6.38±0.55,比重为1.012±0.003,其腰麻合剂pH为6.12±0.46,比重为1.012±0.003。结论 氯普鲁卡因可安全有效地用于腰麻。

The clinical observe of chloroprocaine use for spinal anesthesia

Objective To study possibility and safety of domestic chloroprocaine use for spinal anesthesia.Methods 40 patients were punctured from lumbar 3-4 spinal interspace and injected a 2.2ml mixture(2.5% chloroprocaine 1.2ml,10% glucose 0.5ml,3% ephedrine 0.5ml) within 30-40 seconds into subarachnoid space.Results(1) Onset time,thoracic 10 pain-free time,time of lower limbs were unable to lift up,time of reaching to the highest nerve block level were,(21.69±9.43)sec,(3.56±0.77)min,(3.56±0.64)min and(7.94±1.02)min,respectively.The highest nerve block mean level was thoracic 5.03±1.27.Time of nerve block fade to thoracic 12,time of lower limbs were able to lift up and time of anesthesia complete disappearance were,(56.67±8.47)min,(67.94±12.85)min and(76.95±17.17)min,respectively.(2) No one of patients complained surgery pain.(3) No hypotensions occur after anesthesia.(4) No nausea and vomiting during operation.(5) We could not any observe general and spinal nerve toxic responses.(6) The pH and density of 2.5% chloroprocaine were 6.38±0.55 and 1.012±0.003,respectively.The pH and density of its spinal anesthesia mixture were 6.12±0.46 and 1.012±0.003,respectively.Conclusion 2.5% chloroprocaine can use for spinal anesthesia safely and effectively.