术后镇痛罗哌卡因最小运动阻滞浓度的测定  

Determination of minimal motor-blocking local analgesic concentration of epidural ropivacaine in the postoperative analgesia

作　　者：刘松[1] 周胜岐[1] 赵继英[1] 崔新亮[1] 

机构地区：[1]蚌埠医学院第二附属医院麻醉科,安徽蚌埠233000

出　　处：《淮海医药》2010年第1期1-3,共3页Journal of Huaihai Medicine

基　　金：安徽省高校省级自然科学研究项目(KJ2008B98ZC)

摘　　要：目的测定硬膜外术后镇痛中罗哌卡因的最小运动阻滞浓度（minimal motor-blocking local analgesic con-centration,MMLAC）。方法选择30例妇科手术患者,在术前硬膜外给予罗哌卡因10 ml,第1例患者罗哌卡因的浓度为0.660%,下1例患者的药物浓度根据前1患者有无运动阻滞情况来上调或下调1个浓度级。注药30 min后Bromage评分〈4分定为运动阻滞有效。结果用序贯法测得妇科手术硬膜外镇痛中罗哌卡因的最小运动阻滞浓度为0.706%,95%的可信区间为（0.6852%-0.7272%）。结论本研究测定的罗哌卡因最小运动阻滞浓度,对术后硬膜外镇痛中罗哌卡因的合理应用有一定的理论指导意义。Objective The aim of this study was to determine the minimal motor-blocking concentration of epidural ropivacaine in the postoperative epidural analgesia Methods Thirty ASA I women who underwent gynaecologic operation and requested epidural analgesia were enrolled in the study. Epidural catheter was placed at L2 - 3 and advanced for 3cm in the epidural space in a cephalad direction. Each received a 10 ml bolus of epidural ropivacaine. The first woman received 0.660%. Up-down sequential allocation was used to determine subsequent concentration： to increase the concentration by one level if the previous woman did not respond and to reduce the concentration by one level if the previous woman did respond. The up down sequences were analyzed by using the Brownlee method to quantify the minimal motor-blocking local analgesic concentration. TWO-sided P 〈 0. 05 was defined as significance. Results The minimal motor-blocking concentration of epidural ropivacaine in the post-operative epidural analgesia was 0.706% （95% confidence interval[ CI], 0.6852% - 0.7272% ）. Conclusion The minimal motor-blocking local analgesic concentration of ropivacaine quantified in this study is a theoretic guideline for the clinical use of ropivacaine in the post-operative epidural analgesia.

关 键 词：罗哌卡因 酰胺类 镇痛 硬膜外 剂量效应关系 运动阻滞 

分 类 号：R614.42[医药卫生—麻醉学]