布比卡因、左旋布比卡因及罗哌卡因蛛网膜下腔分娩镇痛的最小有效剂量  

The minimum effective dose of bupivacaine, levobupivacaine and ropivacaine in subarachnoid cavity for labor analgesia

作　　者：张绪东[1] 黄科昌[2] 赵金玉[1] 韩萍[1] 侯明滨[1] 

机构地区：[1]山东省潍坊市妇幼保健院麻醉科,261011 [2]潍坊医学院附属医院麻醉科

出　　处：《中国医师进修杂志》2007年第12期12-14,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 测定布比卡因、左旋布比卡因和罗哌卡因蛛网膜下腔分娩镇痛的最小有效剂量（MLAD）。方法 初产妇60例，ASAⅠ-Ⅱ级，妊娠≥36周，随机分为三组，每组20例。B组：布比卡因复合5μg/ml芬太尼；L组：左旋布比卡因复合5μg/ml芬太尼；R组：罗哌卡因复合5μg/ml芬太尼。宫口开2—3cm时蛛网膜下腔注药，用序贯试验法测MLAD。各组初始剂量均为0．96mg，按1．2倍的阶梯增减，最大剂量为2．39mg。结果当复合5μg/ml芬太尼时，布比卡因、左旋布比卡因、罗哌卡因蛛网膜下腔分娩镇痛的ED50值分别为1．60mg（95％CI1．43—1．79mg），1．63mg（95％CI 1．48～1．80mg）和1．51mg（95％CI 1．38～1．66mg），三组之间差异无统计学意义（P〉0．05）。结论布比卡因、左旋布比卡因和罗哌卡因用于蛛网膜下腔分娩镇痛的最小有效剂量相似。Objective To compare the minimum effective dose of bupivacaine, levobupivacaine and ropivacaine in subaraehnoid cavity for labor analgesia by sequential experimental method. Methods Sixty parturients women of 36 - 42 weeks gestation, ASA Ⅰ -Ⅱ, were randomly assigned to three groups, twenty cases each group. The patients were given spinal administration with bupivacaine （group B ）, levobupivacaine （ group L）, ropivacaine （ group R）, and all anesthetics contained fentanyl 5 μg/ml. The dose of local anaesthetic was determined by the response of the previous parturient to a higher or lower concentration. When cervix dilated to 2-3 cm,the parturient was injected through subaraehnoid cavity at the same time using doubled-blind, up-and-down sequential allocation to measure MLAD. The initial dose in each group was 0.96 mg,with increasing the dose by 1.2 times gradually to the maximum dose of 2.39 rag. Results The ED50 of spinal local anaesthetic for labor analgesia was 1.60 mg （95%CI 1.43-1.79 mg） in group B, 1.63 mg （95%CI 1.48 -1.80 mg） in group L and 1.51 mg （95% CI 1.38-1.66 mg） in group R when they were com bined with fentanyl 5 μg/ml without significant differences among three groups （P 〉 0.05）. Conclusion The minimum effective dose of bupivacaine, levobupivaeaine and ropivaeaine in subarachnoid cavity for labor analgesia is similar.

关 键 词：酰胺类 注射 脊髓 镇痛 产科 序贯试验法 

分 类 号：R714[医药卫生—妇产科学]