老年患者左旋布比卡因硬膜外运动阻滞的半数有效浓度  

The median effective concentration of levobupivacaine for motor blockade during epidural anesthesia in the elderly

作　　者：林慧[1] 陈勇[1] 梁敏[1] 黄文起[2] 

机构地区：[1]海南省人民医院麻醉科,海口市570311 [2]中山大学附属第一医院麻醉科

出　　处：《临床麻醉学杂志》2009年第6期471-473,共3页Journal of Clinical Anesthesiology

摘　　要：目的研究老年和青壮年患者左旋布比卡因硬膜外运动阻滞的半数有效浓度(EC50)。方法60例下肢或下腹部择期手术患者分成老年组(A组,≥70岁)和青壮年组(Y组,<70岁),每组30例。硬膜外穿刺置管后注入15ml不同浓度的左旋布比卡因:每组第一位患者左旋布比卡因浓度均定为0.375%,其后各患者所用浓度按序贯法进行选择,浓度变化梯度定为0.025%。以改良Bromage评分法判断运动阻滞程度,计算硬膜外左旋布比卡因运动阻滞的EC50。结果A组左旋布比卡因硬膜外运动阻滞的EC50为0.349%(95%可信区间:0.327%～0.373%),显著低于Y组的0.453%(95%可信区间:0.424%～0.484%)(P<0.01)。结论与青壮年患者相比,老年患者左旋布比卡因硬膜外运动阻滞的EC50明显降低。Objective To investigate the median effective concentration （EC50） of levobupivacaine for motor blockade during epidural anesthesia in the elderly. Methods Sixty patients undergoing lower abdominal or lower extremity surgery were divided into elder group（≥70 years old, group A） and younger group（〈70 years old,group Y） with 30 cases each. The patients of two groups received a bolus of 15 ml levobupivacaine through the epidural catheter. The concentration for the first patient of each group was 0.375% and the concentration of levobupivacaine for the next was determined according to up-down sequential allocation with the testing interval of 0. 025 %. The plane of motor blockade was scored with modified Bromage motor scale and then the EC50 for motor blockade was calculated. Results The EC50 of levobupivacaine for motor blockade was 0. 349 % （95 % confidence interval was 0. 327 % to 0. 373%） in group A, which was significantly lower than 0. 453 % （95% confidence interval was 0. 424% to 0. 484%） in group Y（P〈0. 01）. Conclusion The EC50 of levobupivacaine for motor blockade after epidural administration is lower in the elderly than that in the younger.

关 键 词：左旋布比卡因 硬膜外阻滞 半数有效浓度 老年 

分 类 号：R614[医药卫生—麻醉学]