腰麻选择布比卡因还是丙胺卡因？( 二 )

OBJECTIVES
We aimed to investigate whetherhyperbaric prilocaine would offer a shorter motor block and recovery thanbupivacaine, when comparing equipotent doses. We also assessed thecharacteristics of sensory block, maternal haemodynamics and side effects forboth mother and newborn.
DESIGN
Prospective, randomised, double-blind,controlled, two-centre, clinical trial.
SETTING
One university teaching hospital and onegeneral teaching hospital in Brussels, Belgium.
PATIENTS
American Society of Anesthesiologists’physical status 2 parturients (n = 40) undergoing caesarean section underspinal anaesthesia.
INTERVENTIONS
Patients were randomly assigned toreceive spinal anaesthesia using hyperbaric prilocaine 50 mg or hyperbaricbupivacaine 10 mg, both given with sufentanil 2.5 μg and morphine 100 μg. Anepidural catheter was introduced as a backup in case of failure.
MAIN OUTCOMES
The primary outcome was the motor blockregression (modified Bromage scale 1 to 6). Secondary outcomes included sensoryblock characteristics, first unassisted ambulation, maternal side effects,newborns’ parameters and overall satisfaction.
RESULTS
Median [IQR] motor block was significantlyshorter in the hyperbaric prilocaine group (110 [104 to 150] min versus 175[135 to 189] min, P = 0.001). First unassisted ambulation was achieved earlierafter prilocaine (204.5 [177 to 46.5] min versus 314 [209.25 to 400] min, P =0.007), and the incidence of maternal hypotension was significantly higher withbupivacaine (P = 0.033). No supplementary epidural analgesia was needed.
CONCLUSION
Prilocaine provides shorter motorblock, faster recovery and better haemodynamic stability than bupivacaine whileoffering equivalent surgical anaesthesia.
【腰麻选择布比卡因还是丙胺卡因？】TRIAL REGISTRATION