摘要
目的探讨罗哌卡因在外周神经刺激仪(PNS)引导下行连续腘窝坐骨神经阻滞时感觉消失的半数有效浓度。方法对22例拟行单侧下肢足踝部手术的患者采用PNS引导腘窝坐骨神经阻滞,罗哌卡因浓度为0.27%、0.30%、0.33%、0.36%、0.39%,容量为30mL。罗哌卡因的浓度从0.33%开始,随后的浓度按序贯法确定:即前例患者在注入局麻药物30min后仍有疼痛感,则下例患者提高1个浓度梯度,否则降低1个浓度梯度,各相邻浓度之间相差0.03%。结果罗哌卡因在连续腘窝神经阻滞消失时的半数有效浓度(Ce50)为0.318%,95%可信区间(CI95)为0.284%～0.351%。95%的有效浓度(Ce95)为0.37%,CI95为0.342%～0.625%。结论浓度为0.37%的罗哌卡因可提供满意的下肢手术感觉阻滞麻醉,有效地减少了麻醉药物的使用剂量,预防麻醉相关并发症的发生,可为临床合理用药时提供参考。
Objective To determine the half-effective target effect-site concentration（Ce50） of ropivacaine on sensation desperation by peripheral nerve stimulator to induce continuous popliteal sciatic nerve block.Methods The patients undergoing selective single side crura foot ankle surgery under popliteal sciatic nerve blockade by peripheral nerve stimulator were enrolled in this study.Concentration of ropivacaine was 0.27%,0.30%,0.33%,0.36% and 0.39%,the volume was 30 mL.The concentration of ropivacaine began with 0.33%,the sequence concentration was determined by up and down depending on success or failure blockade to the previous volume after 30 min,the amount for the next patient was adjusted up or down one concentration.The discrepancy concentration was 0.03%.Results The Ce50 of ropivacaine on sensation disspearation by peripheral nerve sitmulator to induce continuous popliteal sciatic nerve block was 0.318%,95% confidence interval（CI95） was 0.284%-0.351%.95% effective target effect-site concentration（Ce95） was 0.37%,CI95 was 0.342%-0.625%.Conclusion Concentration of 0.37% ropivacaine provides satisfactory sensory block anesthesia of lower limb surgery,effectively reduces the dosage of the narcotic drug,prevents the occurrence of anesthesia-related complications,and can provide a reference for clinical medication.
出处
《新疆医科大学学报》
CAS
2012年第10期1404-1407,共4页
Journal of Xinjiang Medical University
关键词
罗哌卡因
神经阻滞
外周神经刺激仪
半数有效浓度(Ce50)
腘窝坐骨神经
Ropivacaine
nerve block
peripheral nerve stimulator
the half-effective target effect-site concentration
popliteal sciatic nerve
