硬膜外麻醉时调整利多卡因pH值的临床观察

CLINCAL OBSERVATION OF THE INFLUENCE OF LIDOCAINE PH ON THE EFFECT OF EPIDURAL ANESTHESIA

为缩短局麻药的超效时间,增强硬膜外麻醉效果,采用调整局麻药pH的方法对20例病人进行观察、对比。另外,为明确pH增高时对神经组织的影响,用活体家兔坐骨神经试验,电镜观察见pH7.22时对神经影响轻微。

In order to reinforeing and accelerating the initial anesthetic effect of the local anesthetic agent,the pH value of the lidocaine was adjuted during epidural anesthesia.20 parients were observed and compared with the control.It was showed that the time of anesthetic effect of 1.6% lidocaine and sodium bicarbonate(pH7.22)series was 2.463±0.936min,while those of control series,1.6%lidocaine(pH4.72)was 4.327±0.78 min(p<0.01),the time of complete anesthesia was 7.092±2.047min and 9.795±0.874min respectively(p<0.01).Animal experiment demonstrated that there was onlya mild reaction on rabbit's sciatic nerve,while the lidocaine pH was at 7.22 and severe reaction while pH at 7.41 under electron mieroscopic study.But the Latter recovered within 3 days completely.No adverse reaction was observed on lidocaine pH 7.22 sories clinically.However,this method should be applied cautiously on critical and elderly patients for its possible unfavorable response of quick initial effect or strengthen action of anesthetic.