Abstract
Spinal anaesthesia with 2, 2.5 or 3 ml of glucose-free lidocaine 2% was studied in 50 patients undergoing Caesarean section. Onset time, cephalad spread of analgesia, quality of analgesia, muscle relaxation, the cardiovascular effects and duration of analgesia and motor block were assessed. Reliable anaesthesia was provided with 2.5 and 3 ml while 2 ml of 2% lidocaine was insufficient. Onset time varied between 5.5 to 6 min and maximum cephalad spread was achieved in 10–15 min. The mean maximum extent of sensory analgesia was higher after 2.5 ml (T4.1) and 3 ml (T3.6) than after 2 ml (T7) (P < 0.001). Complete motor block was achieved in all the patients. The mean duration of sensory block was 123 ± 6.23 min (2 ml) to 126 ± 7.53 min (2.5 and 3 ml). The mean duration of motor block in 2.5 and 3 ml groups was higher (P < 0.001) than in the 2 ml group and was correlated with the dose of lidocaine (P < 0.05). Hypotension (SBP < 100 mmHg) was noted in 10% (n = 5) of patients in whom the cephalad spread of analgesia was also higher. All the neonates had an apgar score of 7 or more at 1 min. These results suggest that 2.5 to 3 ml of 2% lidocaine provides satisfactory anaesthesia for Caesarean section.
Résumé
Ce travail évalue la qualité de la rachianesthésie réalisée avec de la lidocaine 2% sans glucose chez 50 patientes opérées pour césarienne. La vitesse d’installation, la progression céphalique, la qualité de l’analgésie, la relaxation musculaire, les effets cardiovasculaires et la durée de l’analgésie et du block moteur sont analysés. Une anesthésie efficace est obtenue avec 2,5 et 3 ml contrairement aux 2 ml de lidocaine 2%. La vitesse d’installation varie entre 5,5 et 6 min et la progression maximale est complétée après 10–15 minutes. L’extension maximale moyenne de l’analgésie est plus grande avec 2,5 ml (T4.1) et 3 ml (Ts,6) qu’aprés 2 ml (T7) (P < 0,001). On a obtenue un block moteur complet chez toutes les patientes. La durée moyenne du block sensitif est de 123 ± 6,23 min (2ml) à 126 ± 7,53 min (2,5 et 3 ml). La durée moyenne du block moteur dans les groupes ayant reçu 2,5 et 3 ml est plus longue (P < 0.001) que chez celles qui ont reçu 2 ml avec une corrélation positive pour la posologie (P < 0,05). On a relevé de Vhypotension (PAS < 100 mHg) chez 10% (n = 5) des patientes chez lesquelles la progression céphalique était la plus élevée. Tous les nouveaux-nés cotaient 7 ou plus sur l’échelle d’Apgar à la premiére minute. Ces résultats suggérent que 2,5 à 3 ml de lidocaine 2% procurent une anesthésie satisfaisante pour la césarienne.
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Kumar, A., Bala, I., Bhukal, I. et al. Spinal anaesthesia with lidocaine 2% for Caesarean section. Can J Anaesth 39, 915–919 (1992). https://doi.org/10.1007/BF03008339
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DOI: https://doi.org/10.1007/BF03008339