剖宫产术患者左旋布比卡因蛛网膜下腔阻滞的量效关系  

Dose-response relationship of levobupivacaine for spinal anesthesia in patients undergoing cesarean section

作　　者：姚玉笙[1] 陈彦青[1] 甘秀峰[1] 

机构地区：[1]福建医科大学省立临床医学院福建省立医院麻醉科,福州市350001

出　　处：《中华麻醉学杂志》2009年第5期450-452,共3页Chinese Journal of Anesthesiology

摘　　要：目的确定剖宫产术患者左旋布比卡因蛛网膜下腔阻滞的量效关系。方法择期剖宫产术患者60例，年龄25～35岁，体重60～90kg，ASAⅠ或Ⅱ级，随机分为4组（n=15），于L3,4蛛网膜下腔穿刺成功后，分别注射左旋布比卡因7．5mg（L1组）、10mg（L2组）、12．5mg（k组）和15mg（k组），均用5％葡萄糖稀释至3ml，注药时间30s。采用视觉模拟评分法（VAS）评价切皮即刻患者疼痛程度，0分为无痛，10分为剧痛。VAS评分=0分为镇痛有效；VAS评分≥1分为镇痛无效，硬膜外追加1％利多卡因5～10ml。采用Probit法计算50％和95％患者镇痛有效的左旋布比卡因剂量（ED30和ED95）及其95％可信区间。结果左旋布比卡因的ED50及其95％可信区间为9．0（7．8～9．9）mg，EDq5及其95％可信区间为13．2（11．6～17．6）mg。结论剖宫产术患者左旋布比卡因蛛网膜下腔阻滞的ED50和ED95分别为9．0、13．2mg。Objective To investigate the dose-response relationship of levobupivacaine for spinal anesthesia in patients undergoing cesarean section. Methods Sixty ASA Ⅰ or Ⅱ patients aged 25-35 yr weighing 60-90 kg scheduled for elective cesarean section under spinal anesthesia were enrolled in this study. Spinal puncture was performed at the L3.4 interspace. A 25 G spinal needle was inserted into the subaraehnoid space cephalad. The patients were randomized to receive levobupivacaine 7.5 mg （group L1 ）, 10 mg （group L2 ）, 12.5 mg （group L3） or 15 mg （group L4） diluted to 3 ml with 5% glucose over 30 s （n = 15 each）. The degree of pain was evaluated at the time of skin incision using visual analogue scales （VAS） （0 = no pain and 10 = worse pain ever）. Effective analgesia was defined as VAS = 0. Spinal analgesia was inadequate when VAS≥ 1 and then 1% lidocaine 5-10 ml was given epidurally. The doses of levobupivacaine for effective analgesia in 50% and 95 % of patients （ED50 and ED95 ） and 95 % confidence interval were calculated by Probit method. Results The ED50 of levobupivacaine was 9.0 mg （95% confidence interval 7.8-9.9 mg） and ED95 13.2 mg （95% confidence interval 11.6-17.6 mg） for spinal anesthesia. Conclusion The ED50 and ED95 of levobupivacaine for spinal anesthesia in patients undergoing cesarean section are 9.0 mg and 13.2 mg respectively.

关 键 词：布比卡因 麻醉 脊椎 剂量效应关系 药物 剖宫产术 

分 类 号：R614[医药卫生—麻醉学]