摘要
目的研究罗哌卡因蛛网膜下腔阻滞用于剖宫产的量效关系。方法择期剖宫产患者100例,随机、双盲分为四组。于L2-3间隙蛛网膜下腔穿刺成功后,分别注射罗哌卡因15mg(A组)、17.5mg(B组)、20mg(C组)、22.5mg(D组)。采用针刺法测定感觉阻滞平面,改良Bromage评分法测定下肢运动神经阻滞程度,VAS评分评估患者疼痛程度,术者评定腹壁松弛度,记录麻醉后不良反应。采用Probit法计算50%和95%患者镇痛有效的罗哌卡因剂量(ED50和ED95)及其95%可信区间(CI)。结果随着剂量加大,运动阻滞起效时间逐渐缩短,Bromage评分逐渐增高,感觉和运动恢复时间逐渐延长。四组镇痛有效率分别为36%、64%、96%、100%,腹壁松弛度"很松"的分别为24%、48%、92%、100%。麻醉后不良反应少。罗哌卡因的ED50为15.95mg(95%CI15.31～16.62mg),ED95为18.76mg(95%CI17.67～19.54mg)。结论国人罗哌卡因用于剖宫产蛛网膜下腔阻滞的ED50为15.95mg,ED95为18.76mg。
Objective To evaluate effect of ropivacaine used in spinal anesthesia on cesarean section. Methods One hundred patients undergoing elective cesarean section were randomly divided into 4 groups： group A （ropivacaine 15 mg） ,group B （ropivacaine 17.5 mg）,group C （ropivacaine 20mg） and group D （ropivaeaine 22.5mg）. All the groups were punctured in 1-23 interspace, then ropivacaine was injected into the subarachnoid space. The sensory block level, Bromage score were recorded. The degree of pain was evaluated using visual analogue scales（VAS）. The relaxiation of the abdominal wall muscle was evaluated by the surgeon. Adverse reactions after anesthesia were recorded. The doses of ropivacaine for effective analgesia in 50% and 95% of patients （ED50 and ED95） and 95% confidence interval （CI） were calculated by Probit method. Results As the close increased, motor block onset time shortened gradually, Bromage score increased gradually, sensory and motor recovery time is prolonged gradually. Analgesic efficacy of group A-D were 36%, 64%, 96%, 100%. The incidence rate of ＂very loose＂ abdominal wall evaluated by the surgeon were 24%, 48%, 92%, 100% respectively. Adverse reactions after anesthesia were fewer. The ED50 of ropivacaine was 15.95 mg（95% CI 15.31-16.62 rag） and ED55 18. 76 mg（95% CI 17.67-19.54 mg）. Conclusion The ED50, ED95 of ropivaeaine used in spinal anesthesia for cesarean section was 15.95 mg and 18.76 mg.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2010年第8期699-701,共3页
Journal of Clinical Anesthesiology
关键词
罗哌卡因
蛛网膜下腔阻滞
剖宫产
量效关系
Ropivacaine
Spinal anesthesia
Cesarean section
Dose-response relationship
