术后镇痛中罗哌卡因和布比卡因运动阻滞效能比较  

Relative motor-blocking potencies of epidural ropivacaine and bupivacaine 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233040

出　　处：《蚌埠医学院学报》2010年第9期893-895,共3页Journal of Bengbu Medical College

基　　金：安徽省高校省级自然科学研究资助项目(KJ2008B98ZC)

摘　　要：目的:测定硬膜外术后镇痛中罗哌卡因和布比卡因的最小运动阻滞浓度(EC50),并对其运动阻滞效能进行比较。方法:将60例行妇科手术并要求硬膜外镇痛的患者随机分为2组,每组30例。经硬膜外导管留置于L2～3间隙,留置导管长度为3cm.分别给予罗哌卡因或布比卡因溶液10 ml。注药前和注药后30 min进行Bromage运动评分。2组患者硬膜外起始用药浓度分别为0.660%罗哌卡因,0.400%布比卡因,按照序贯法来调整每组下1例患者用药的浓度。结果:硬膜外术后镇痛中罗哌卡因EC50为0.706%;布比卡因EC50为0.443%。罗哌卡因运动阻滞的效能为布比卡因的0.63,95%的可信区间为(0.60～0.66)。结论:硬膜外罗哌卡因的运动阻滞效能小于布比卡因,仅为布比卡因运动阻滞效能的63%。Objective：To determine the minimal motor-blocking concentration（EC50） of epidural ropivacaine and bupivacaine in the postoperative epidural analgesia,and compare the relative potency of these drugs used in epidural space.Methods：Sixty ASA I women who went gynaecologic operation and requested epidural analgesia were randomized to receive either ropivacaine or bupivacaine.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 or bupivacaine.Half an hour before and after the bolus,take a Bromage score to compare.Up-down sequential allocation was used to determine subsequent concentration： to increase the concentration one level if the previous woman did not respond and to reduce the concentration 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.Results：The ropivacaine was 0.706% and for bupivacaine was 0.443% with a ropivacaine/bupivacaine potency ratio of 0.63（95% CI,0.60-0.66）.Conclusions：Ropivacaine was significantly less potent for motor block,at 63% that of bupivacaine.

关 键 词：镇痛药 硬膜外 酰胺类 药效动力学 运动阻滞 

分 类 号：R971.1[医药卫生—药品]