分娩镇痛中左旋布比卡因最小运动阻滞浓度的临床研究  

Determination of Motor Block Minimal Local Analgesic Concentration of Epidural Levobupivacaine in First Stage of Labor

作　　者：刘松[1] 赵汝有[1] 周胜岐[1] 赵继英[1] 

机构地区：[1]安徽省蚌埠医学院第二附属医院麻醉科,233000

出　　处：《中华全科医学》2009年第2期115-117,共3页Chinese Journal of General Practice

摘　　要：目的测定国人第一产程硬膜外分娩镇痛中左旋布比卡因的最小运动阻滞浓度(MMLAC)。方法选择30例单胎足月初产妇,在进入第一产程活跃期时硬膜外给予负荷量左旋布比卡因10ml,第一例左旋布比卡因的浓度为0.5%,下一例产妇的药物浓度应用序贯法根据前一产妇有无运动阻滞情况来上调或下调一个浓度级。注药30min后Bromage评分<4分定为有运动阻滞。结果本实验用序贯法测得在国人第一产程分娩镇痛中左旋布比卡因的最小运动阻滞浓度为0.562%,95%的可信区间为(0.542%～0.584%)。结论在第一产程分娩镇痛中左旋布比卡因的最小运动阻滞浓度为0.562%,可以为国人的临床应用提供药效动力学参考。Objective To determine the motor block minimal local analgesic concentration of epidural levobupivacaine in the first stage of labor. Methods Thirty ASA I nulliparous women with 2-3 cm cervical dilatation who requested epidural analgesia were enrolled in the study. The load amount of levobupivacaine was administered for epidural analgesia. Each received a 10 ml bolus of epidural levobupivacaine. The first woman received 0.5% levobupivaeaine. Up-down sequential allocation was used to determine subsequent concentration： to increase the concentration one level if the previous woman did not respond or reduce the concentration one level if the previous woman did respond. The Brownlee method was used to quantify the motor block minimal local analgesic concentration 30 min after injection. Results The motor block concentration of epidural levobupivacaine in the first stage of labor in China was 0.562% wt/vol （95% confidence interval[ CI ] ,0.542% -0.584% ）. Conclusion In the first stage of labor the motor block concentration of eprdural levohupivacaine was 0. 562% , this result can provide pharmacody namics reference for the clinical application.

关 键 词：酰胺类 镇痛 硬膜外 剂量效应关系 

分 类 号：R714.3[医药卫生—妇产科学]