老年患者蛛网膜下腔注射左旋布比卡因、罗哌卡因和布比卡因运动阻滞效能的比较  

The relative potencies for motor block after intrathecal levobupivacaine,ropivacaine and bupivacaine for elderly patients

作　　者：郑彬[1] 傅文婷[1] 曾彦茹[1] 许立新[1] 许学兵[1] 佘守章[1] 

机构地区：[1]广州医学院附属广州市第一人民医院麻醉科,510180

出　　处：《实用医学杂志》2011年第5期859-861,共3页The Journal of Practical Medicine

摘　　要：目的:比较老年患者蛛网膜下腔注射左旋布比卡因、罗哌卡因和布比卡因运动阻滞的效能。方法:拟在腰麻-硬膜外联合麻醉下行下腹部手术的老年患者,随机分成左旋布比卡因组(L组)、罗哌卡因组(R组)和布比卡因组(B组)。采用序贯法进行试验,每组第1例患者局麻药剂量均为5mg,剂量变化梯度为1mg。运动阻滞有效定义为蛛网膜下腔注药后20min内任何一侧下肢改良Bromage评分大于或等于1分。计算两种药物运动阻滞的半数有效剂量(ED50)和95%可信区间(95%CI)。结果:左旋布比卡因运动阻滞的ED50为5.483mg;罗哌卡因运动阻滞的ED50为7.516mg;布比卡因运动阻滞的ED50为4.277mg。结论:老年患者蛛网膜下腔注射三种局麻药的运动阻滞效能从高到低依次是布比卡因、左旋布比卡因和罗哌卡因,后两者感觉-运动阻滞分离的优势更明显。Objective To compare the relative motor blocking potencies of intrathecal levobubivacaine,ropivacaine and bupivacaine.Methods ED50 was determined by up-down sequential method.Ninety ASA I or II elderly patients undergoing elective lower abdominal surgery were randomly divided into 3 groups receiving intrathecal 0.5% levobupivacine,ropivacaine and bubivacaine,respectively.The initial dose was 5 mg and the testing interval was set at 1 mg.Efficacy was determined by the occurrence of any motor block in either lower limb（modified Bromage scale≥1）within 20 min after the spinal injection.Results Intrathecal ED50 for motor block was 5.483 mg for levobupivacine,7.516 mg for ropivacaine,and 4.277 mg for bupivacaine.Conclusion There is a clinical profile of potency for motor block when administered spinally：high,intermediate,and low for bupivacaine,levobupivacaine and ropivacaine,respectively.

关 键 词：麻醉 脊椎 剂量效应关系 药物 罗哌卡因 布比卡因 

分 类 号：R614[医药卫生—麻醉学]