科研之友
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摘要
Background: Studies have shown that abdominal girth and vertebral column length have high predictive value for spinal spread after administering a dose of plain bupivacaine. we designed a study to identify the specific correlations between abdominal girth, vertebral column length and a 0.5 % dosage of plain bupivacaine, which should provide a minimum upper block level (T-12) and a suitable upper block level (T-10) for lower limb surgeries. @@@ Methods: A suitable dose of 0.5 % plain bupivacaine was administered intrathecally between the L-3 and L-4 vertebrae for lower limb surgeries. If the upper cephalad spread of the patient by loss of pinprick discrimination was T-12 or T-10, the patient was enrolled in this study. Five patient variables and intrathecal plain bupivacaine dose were recorded. Linear regression and multiple regression analyses were performed. @@@ Results: Totals of 111 patients and 121 patients who lost pinprick discrimination at T-12 and T-10, respectively, were analyzed in this study. Linear regression analysis showed that only abdominal girth and plain bupivacaine dose were strongly correlated (r = -0.827 for T-12, r = -0.806 for T-10; both p < 0.0001). Multiple linear regression analysis showed that both abdominal girth and vertebral column length were the key determinants of plain bupivacaine dose (both p < 0.0001). R-2 was 0.874 and 0.860 for the loss of pinprick discrimination at T-12 and T-10, respectively. @@@ Conclusions: Our data indicated that vertebral column length and abdominal girth were strongly correlated with the dosage of intrathecal plain bupivacaine for the loss of pinprick discrimination at T-12 and T-10. The two regression equations were Y-T12 = 3.547 + 0.045X(1)-0.044X(2) and Y-T10 = 3.848 + 0.047X(1)-0.046X(2) (Y, 0.5 % plain bupivacaine volume; X-1, vertebral column length; and X-2, abdominal girth), which can accurately predict the minimum and suitable intrathecal bupivacaine dose for lower limb surgery to a great extent, separately.
