- 期刊
麻醉藥劑量對等比重Tetracaine脊髓麻醉之影響
Effects of Drug Dose on Spinal Anesthesia with Isobaric Tetracaine
摘要
本文是這一系列脊髓麻醉研究之另一部份，以128位成人患者隨機分成三組，以相同容量（2 ml）之等比重tetracaine作脊髓麻醉。第一組50位，劑量為10 mg；第二組46位，劑量為15 mg；第三組32位，劑量為20 mg。麻醉實施細則與本系列其他研究同。各項因素均予嚴格控制，唯一變數是所使用tetracaine之劑量（dosage）各組不同。結果顯示以tetracaine作等比重脊髓麻醉峙，如若麻醉藥液之容量相等，則其麻醉藥效將因劑量加大而增加，即麻醉脊位高而持久（低脊位處較明顯），但其到達最高脊位之時間則將相對延長，唯其到達T_(10)脊位之時間及「二節減退時間」（2-segment regression time）則無顯著差別。當劑量超過15 mg時，前述麻醉增強之效益不再顯著。因此，我們認為於臨床麻醉時，tetracaine之劑量毋需超過15 mg。
並列摘要
A protocol similar to that established in our previous reports was used in the current study. A total of 128 demographically compatible patients were studied using various tetracaine dosages in 2 ml isobaric solution; fifty patients (group I) received 10 mg, 46 patients (group II) received 15 mg, and 32 patients (group III) received 20 mg. Except for the drug dosage, an identical technique was employed for every patient in the study. The highest sensory levels were T_7 (median, range T_(5-12)) for group I, T_5 (median, range T_(3-8)) for group II, and T_4 (median, range C_8-T_5) for group III, with an onset time of 7.08 ± 1.16, 10.37 ± 1.69 and 11.14 ± 1.85 min respectively. The above differences are statistically significant (p ＜ 0.05). However the differences between their onset times to the T_(10) level were not statistically significant (p ＞ 0.05). The 2-segment regression times were 180.5 ± 53.44 min for group I, 216.4 ± 37.3 min for group II and 248.7 ± 38.6 min for group III. The difference between group I and group II as well as group I and group III were statistically significant (p ＜ 0.01) but not significant between group II and group III (p ＞ 0.05). The onset times of maximum motor blockade assessed by modified Bromage scale were 5.42 ± 1.59, 5.28 ± 1.36 and 5.37 ± 1.42 min. The difference was not statistically significant (p ＞ 0.05). Nonetheless, the difference between the degree of maximum motor blockade was statistically significant when compared group I with group II, or group I with group III but not significant between group II and group III. These findings show that when isobaric tetracaine is used for spinal anesthesia, the level as well as the duration of blockade will increase when the drug dose is increased. However, no statistically significant difference was found between the 15 mg and 20 mg groups. This indicates that there are no advantages in using more than 15 mg of tetracaine for isobaric spinal anesthesia.