CLINICAL STUDIES ON TOTAL SPINAL BLOCK

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  • Masuda Yutaka
    Department of Anesthesiolog Showa University School of Medicine

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  • 全脊髄麻酔の臨床的研究
  • ゼン セキズイ マスイ ノ リンショウテキ ケンキュウ

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Abstract

A total of 488 total spinal blocks was performed in 66 patients. The indications of the block are cervico-omo-brachial syndrome, whiplash injury, headache, causalgia, phantom limb pain, herpes zoster, postherpetic neuralgia and other diseases. On an average, seven times of the block was given to each patient, maximum was 35 times. Remarkable or satisfactory results were obtained in 54 patients (81.1%), but no improvement in 12 patients. Gas chromatographic analysis of mepivacaine in venous plasma before, during and after the block was carried out in ten patients. The peak plasma concentration of mepivacaind was detected after 60 minutes of the injection of 300 mg into subarachnoid space, it was 2.15 μg/ml. On the other hand, it needed 120 minutes to reach the peak level, 2.40 μg/ml, in the groupe who received 450 mg of mepivacaine. During the block, any significant changes in blood pressure, pulse rate, and ECG were never observed. EEG findings showed slow wave in almost all cases, but one showed seizure pattern.

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