剖宫产时蛛网膜下隙0.75%罗哌卡因麻醉的ED_(50)  

Determination of the ED_(50) of spinal anesthesia 0.75% ropivacaine for cesarean section

作　　者：沈晓署[1] 甘果[1] 袁力勇[1] 

机构地区：[1]宁波市妇女儿童医院麻醉科

出　　处：《中国临床药理学与治疗学》2008年第8期905-908,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：宁波市医学科技项目(2005538;2006009;2007014)

摘　　要：目的：确定剖宫产时蛛网膜下隙0.75%罗哌卡因（ropivacaine,Rop）麻醉的半数有效剂量（ED50）。方法：32名ASAⅠ-Ⅱ、择期在蛛网膜下隙-硬膜外隙联合麻醉（combined spinal-epidural an-esthesia,CSEA）下剖宫产产妇参加试验。第一位产妇0.75%Rop剂量为12.8mg,以相邻剂量的98.4%为剂量的变化幅度。感觉、运动神经阻滞分别以针刺法及改良Bromage法测定。麻醉有效的指标为：蛛网膜下隙给药后10min内感觉平面阻滞达到T7、Bromage达3分、切皮不痛、肌松满意。计算剖宫产时蛛网膜下隙0.75%Rop麻醉的ED50及其95%可信区间（CI）。结果：32名产妇中有5例麻醉效果可疑,剔除出本研究。根据其余27名产妇序贯试验得出剖宫产时蛛网膜下隙0.75%Rop麻醉的ED50为11.97mg,ED50的95%CI为11.75-12.19mg。结论：L3-4间隙CSEA下剖宫产时,蛛网膜下隙0.75%罗哌卡因麻醉的ED50为11.97mg。AIM： To determine the median effective dose （ED50） of spinal anesthesia 0.75% ropivacaine for cesarean section. METHODS： Thirty-two ASA Ⅰ- Ⅱ parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. The initial dose of was 12.8 mg of 0.75 % ropivacaine, and the dosing intervals were 98.4% of the preceding dosage. Doses for subsequent parturients were determined by the response of the previous parturient. Successful anesthesia was defined as a loss of sensation to an acupuncture stimulus at the T7 level, full motgr blockade within 10 minutes after administration of the local anesthetic, analgesia of incision and the satisfaction of skelaxin eval-uated by one operator. ED50 and its 95 % confidence interval （CI） was determined with use of Dixon method. RESULTS： Five parturients were rejected out the study because of doubtful anesthsia. According to the rest twenty-seven parturients＇ data, the ED50 of intrathecal 0.75 % ropivacaine was 11.97 mg （ 95 % confidence interval [CI], 11 .75 - 12.19 mg）. CONCLUSION： The ED50 of spinal 0.75 % ropivacaine for cesarean delivery under the conditions of this study were 11.97 mg.

关 键 词：剖宫产 蛛网膜下隙-硬膜外隙联合麻醉 罗哌卡因 半数有效剂量 

分 类 号：R614[医药卫生—麻醉学]