妇科硬膜外左旋布比卡因最低感觉及运动阻滞浓度  

The minimal effective concentration of epidural levobupivacaine for sensory and motor block during gynecological surgery

作　　者：李梅娜[1] 贺秋兰[1] 孙来保[1] 汪卫兵[2] 雷亚红[1] 黄文起[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广州市510080 [2]安徽省安庆市立医院麻醉科

出　　处：《临床麻醉学杂志》2010年第8期676-678,共3页Journal of Clinical Anesthesiology

摘　　要：目的测定妇科手术左旋布比卡因最低感觉及运动阻滞浓度即半数有效浓度(EC50)。方法 70例妇科手术患者随机分为感觉组和运动组,每组35例。择L2～3行硬膜外穿刺置管后分次给予预定浓度左旋布比卡因总量为15ml:第一例感觉组浓度为0.150%,运动组为0.375%,其后各患者的药物浓度以序贯法进行选择,相邻级别浓度比感觉组为0.980,运动组为0.944。以VAS和改良Bromage评分法分别判断感觉和运动阻滞程度。结果硬膜外左旋布比卡因感觉阻滞EC50为0.140%(95%CI:0.136%～0.144%),显著低于运动阻滞的EC500.385%(95%CI:0.359%～0.414%)(P<0.01),左旋布比卡因感觉与运动阻滞分离区间是0.140%～0.385%。结论妇科硬膜外左旋布比卡因感觉和运动阻滞EC50分别为0.140%和0.385%。Objective To determine the median effective concentrations （EC50） of epidural levobupivacaine for sensory and motor block during gynecological surgery. Methods Seventy patients undergoing gynecological surgery were randomly allocated into either group S （sensory block） or group M （motor block） with 35 cases each. A bolus of 15 ml levobupivacaine through L2-3 catheter was given to all patients. The first concentrations in group S and group M were 0. 150% and 0. 375%, respectively. The next levobupivacaine concentration was determined according to an updown sequential method, and the ratio of adjacent concentration rank was 0. 980 and 0. 944 in group S and group M, respectively. The levels of sensory and motor block were tested with VAS and modified Bromage scales. Results The ECs0 of tevobupivacaine for sensory block was 0. 140% （95%confidence interval, 95% CI 0. 136% to 0. 144%）, which was significantly lower than 0. 385%（95% CI, 0. 359% to 0. 414%） for motor block （P 〈 0.01）. The interval of sensory-motor separation of levobupivacaine was 0. 14% to 0. 385%. Conclusion The EC50 of epidural levobupivacaine for sensory and motor block is 0. 140% and 0. 385%, respectively.

关 键 词：左旋布比卡因 半数有效浓度 硬膜外阻滞 

分 类 号：R614[医药卫生—麻醉学]