布比卡因腰麻剂量与脊柱长度的关系

Correlation between bupivacaine dosage and length of vertebral column in spinal anaesthesia

目的研究布比卡因腰麻剂量与脊柱长度的关系。方法在复合腰麻硬膜外麻醉下行下腹部、下肢及会阴部手术患者２１２例，按腰麻根据脊柱长度给药和凭临床经验给药分为Ａ、Ｂ两组，各１０６例。患者侧卧位自Ｌ２～３或Ｌ３～４间隙针内针法穿刺，药用５ｇ·Ｌ－１布比卡因含６６７ｇ·Ｌ－１葡萄糖溶液，注速为０１ｍｌ·ｓ－１，组间数据用Ｕ检验，Ａ组腰麻剂量与脊柱长度采用相关与回归分析。结果腰麻效果优：Ａ组８５％，Ｂ组６３％，Ｐ＜００１。Ａ组腰麻剂量与脊柱长度回归方程为：＾Ｙ＝０２５＋００４Ｘ，ｒ＝０８６２。结论布比卡因腰麻剂量与脊柱长度呈高度正相关。

Objective To study the relationship between bupivacaine dosage and length of vertebral column in spinal anaesthesia. Methods 212 cases operated on the lower abdomen, lower limbs and perineum and given combined spinal epidural anaesthesia were classified into A and B groups, each having 106 cases. The bupivacaine dosage was given in group A and B according to the length of vertebral column and clinical experience respectively. The patients were placed in the lateral decubitus position. The lumber puncture was performed on the L 2～3 or L 3～4 interspace with needle through needle technique and injected 5 g·L -1 bupivacaine in 66 7 g·L -1 glucose into the subarachnoid space with 0 1 ml·s -1 . Results The excellent percentage in spinal anaesthesia was 85% and 63% in group A and B respectively( P <0 01). The correlation between 5 g·L -1 dosage(ml) and the length of vertebral column(cm) and the regression analysis in group A showed: =0 25+0 04 X, r=0 862 . Conclusion There is a strong positive correlation between bupivacaine dosage and the length of vertebral column in spinal anaesthesia.