轻比重布比卡因用于老年患者蛛网膜下腔阻滞的最低有效剂量  

Minimum effective local anaesthetic dose of intrathecal hypobaric bupivacaine in the elderly patients

作　　者：彭志勇[1] 王仁儒[1] 黄小琼[1] 彭为平[1] 梁秀萍[1] 郑映金[1] 

机构地区：[1]南方医科大学附属南海医院麻醉科,广东佛山528200

出　　处：《中国现代医学杂志》2013年第9期89-91,共3页China Journal of Modern Medicine

基　　金：佛山市卫生局医学科研立项课题(No:佛科卫2011258)

摘　　要：目的研究轻比重布比卡因用于老年单侧下肢短、中时间手术患者蛛网膜下腔阻滞的最低有效剂量(MLAD)。方法采用序贯法设计,选择在脊椎-硬膜外联合阻滞下择期行单侧下肢手术的老年患者30例,ASAⅡ~Ⅲ级,按设定的剂量梯度及方案给药,测定阻滞平面进行评估麻醉效果,连续监测血压、心率、血氧饱和度、心电图,观察不良反应。根据Dixon-Massey法计算布比卡因的MLAD,即ED50。结果老年患者单侧下肢手术时,轻比重布比卡因蛛网膜下腔阻滞的最低有效剂量4.7 mg,可信区间(95%CI)为4.1 mg^5.2 mg,能满足2 h内蛛网膜下腔阻滞麻醉且血流动力学稳定,术后无需留置导尿。结论轻比重布比卡因4.7 mg为老年单侧下肢短、中时间手术蛛网膜下腔注药的最低有效剂量。【Objective】 To determine the minimum local analgesic dose（MLAD）of intrathecal hypobaric bupivacaine for lower extremity operation in the elderly patients.【Methods】 Designed by up-and-down,thirty ASA II or Ⅲ elderly patients were given bupivacaine as the planned dose gradient.Hemodynamics（MAP,ECG,HR and SpO2）were monitored continuously,untoward effects and retention catheterization were observed Anesthesia effect was assessed by the blocked level.The MLAD（ED50） of bupivacaine was calculated using the method of Dixon and Massey.【Results】 The MLAD of Bupivacaine was 4.7mg（95%CI 4.1mg～5.2mg）,which was used in the elderly patients with spinal anesthesia.for unilateral lower extremity operation during 2 hours.without anesthesia complications like hemodynamic unstabilization or retention catheterization.【Conclusion】 Hypobaric bupivacaine 4.7mg is the minimal and reliable effective-dose to be used in the elderly patients for lower extremity operation with spinal anesthesia,and is highly recommended.

关 键 词：布比卡因 比重 脊椎 麻醉 老年人 

分 类 号：R614.4[医药卫生—麻醉学]