Spinal Anesthesia with Two Different Dosages of 0.75%　Glucose-free Ropivacaine: A Comparison of Efficacy and Safety in Chinese Parturients Undergoing Cesarean Section

以兩種劑量之0.75%不含糖Ropivacaine作脊椎麻醉：於中國人剖腹生產手術麻醉效果及安全性之比較

黃安年(John On-Nin Wong) ； 陳多慕(Thomas Dou-Moo Tan) ； 梁百安(Pak-On Leung) ； 曾慶暉(Kin-Fui Tseng) ； 儲寧瑋(Ning-Wei Cheu)

《Acta Anaesthesiologica Sinica》 41卷3期 (2003/09) Pp. 131-138

https://doi.org/10.6955/AAS.200309.0131

摘要

Background : We compared the clinical efficacy and safety between 2 doses of 2.5 ml (18.75 mg) and 3 ml (22.5 mg) of 0.75% glucose free spinal ropivacaine in Chinese parturients undergoing Cesarean section.
Methods : In this randomized, open-label study, 40 parturients enrolled were divided into two groups: Group A received a 2.5 ml 0.75% ropivacaine asopposed to 3ml in Group B. Sensory andmotor blocks were assessed during and after surgery until complete recovery. Eight standard measurements were taken: time at onset of sensory block; maximum cephalic sensory spread; maximum number of blocked segments; time to maximum sensory block; duration of sensory block at L3; time at onset of complete motorblock and duration until complete recovery. Vital signs and any adverse effects related to spinal anesthesia were also recorded.
Results : Five of the 6 variables showed no significant difference between groups A and B: onset time of sensory block at L3 was 1.8 ± 6.7min vs. 2.3 ± 9.8min; maximum cephalic spread was T3-4 (C3-T7) vs.T3 (C2-T8);maximum number of blocked segments was 20.7 ± 3.5 vs. 20.2 ± 3.4; time to maximum sensory block 15.4 ± 5.5 min vs. 20.3 ±15.1 min; time for regression to L3 was 200.8 ± 59.5 min vs. 215.0 ± 37.6 min and time for complete recovery of motor block 208.5 ± 55.5 min vs. 226.5 ± 46.1 min. Group B had a significantly faster onset time for complete motor block (P ＜ 0.05) 15.4 ± 5.6 min vs. 10.4 ± 4.7 min. Moreover, there were no significant differences in global hem odynamic changes during and after the operation. Transient hypotension attacks were more frequent in group A at the be-ginning of anesthesia, perhaps due to inadequate prehydration. Otherwise, there were no differences in adverse effects during or after surgery.
Conclusions : We conclude that for Cesarean section in Chinese parturients either 18.75 mg (2.5 ml) or 22.5 mg (3 ml) 0.75% glucose-free ropivacaine can provide a spinal anesthesia of the same efficacy and safety.

關鍵字

脊椎麻醉 ； 局部麻醉劑 ； 安全性 ； 剖腹產

並列摘要

Background : We compared the clinical efficacy and safety between 2 doses of 2.5 ml (18.75 mg) and 3 ml (22.5 mg) of 0.75% glucose free spinal ropivacaine in Chinese parturients undergoing Cesarean section.
Methods : In this randomized, open-label study, 40 parturients enrolled were divided into two groups: Group A received a 2.5 ml 0.75% ropivacaine asopposed to 3ml in Group B. Sensory andmotor blocks were assessed during and after surgery until complete recovery. Eight standard measurements were taken: time at onset of sensory block; maximum cephalic sensory spread; maximum number of blocked segments; time to maximum sensory block; duration of sensory block at L3; time at onset of complete motorblock and duration until complete recovery. Vital signs and any adverse effects related to spinal anesthesia were also recorded.
Results : Five of the 6 variables showed no significant difference between groups A and B: onset time of sensory block at L3 was 1.8 ± 6.7min vs. 2.3 ± 9.8min; maximum cephalic spread was T3-4 (C3-T7) vs.T3 (C2-T8);maximum number of blocked segments was 20.7 ± 3.5 vs. 20.2 ± 3.4; time to maximum sensory block 15.4 ± 5.5 min vs. 20.3 ±15.1 min; time for regression to L3 was 200.8 ± 59.5 min vs. 215.0 ± 37.6 min and time for complete recovery of motor block 208.5 ± 55.5 min vs. 226.5 ± 46.1 min. Group B had a significantly faster onset time for complete motor block (P ＜ 0.05) 15.4 ± 5.6 min vs. 10.4 ± 4.7 min. Moreover, there were no significant differences in global hem odynamic changes during and after the operation. Transient hypotension attacks were more frequent in group A at the be-ginning of anesthesia, perhaps due to inadequate prehydration. Otherwise, there were no differences in adverse effects during or after surgery.
Conclusions : We conclude that for Cesarean section in Chinese parturients either 18.75 mg (2.5 ml) or 22.5 mg (3 ml) 0.75% glucose-free ropivacaine can provide a spinal anesthesia of the same efficacy and safety.

並列關鍵字

Anesthesia ； spina. Anesthetics ； local: ropivacaine. Safet ； Cesarean Section