摘要
目的研究剖宫产术患者布比卡因腰麻混合芬太尼时的半数有效剂量。方法择期行剖宫产26例,ASAⅠ-Ⅱ级,于L2-3间隙行脊椎-硬膜外联合穿刺。蛛网膜下隙注射布比卡因混合芬太尼10μg,按照序贯法进行试验,第1例选择布比卡因剂量为4.5 mg,根据腰麻是否有效确定下一例患者的布比卡因剂量,相邻剂量为0.75 mg。腰麻有效的定义为:①腰麻10 min后感觉阻滞平面达到T8;②改良Bromage评分≥1分;③围术期产妇的VAS评分≤2分;④产科医生对肌松效果满意。结果患者蛛网膜下隙注射比卡因的半数有效剂量为3.04 mg(95%可信区间为2.93-3.15 mg)。结论布比卡因混合10μg芬太尼用于剖宫产腰麻的ED50为3.04 mg.
Objective To explore the median effective dose（ED50）of bupivacaine for spinal anesthesia when combined with fentanyl in patients undergoing caesarean section.Methods Twenty-six ASA Ⅰ-Ⅱ patients,undergoing elective caesarean section under spinal-epidural anesthesia,were enrolled in this study.The spinal-epidural anesthesia was performed at L2-3 interspace.The mixture of bupivacaine and 10 μg fentanyl was injected into the subarachnoid space.The ED50 was determined by up-down sequential allocation.The initial dose of bupivacaine was 4.5 mg.The dose was increased/decreased by 0.75 mg in the next patient.The effective definition of spinal anesthesia was as follows：① the sensory block level of spinal anesthesia level reach to T8 after 10 min;②the modified Bromage score ≥ 1;③ the perioperative VAS score of patients ≤ 2;④obstetricians are satisfied to the muscle relax.Results The ED50 of bupivacaine was 3.04 mg（95% confidence interval 2.93-3.15 mg）.Conclusion When combined with fentanyl 10 μg,the ED50 of bupivacaine for spinal anesthesia is 3.04 mg in patients undergoing caesarean section.
出处
《山西医科大学学报》
CAS
2013年第2期155-157,共3页
Journal of Shanxi Medical University
关键词
脊椎麻醉
布比卡因
芬太尼
剂量效应关系
剖宫产术
spinal anesthesia
bupivacaine
fentanyl
dose-effect relationship
caesarean section
