超声引导下锁骨上臂丛神经阻滞罗哌卡因的半数有效浓度  

Median Effective Concentration of Ropivacaine for Ultrasound-Guided Supraclavicular Brachial Plexus Block

作　　者：傅志海[1] 陈再治[1] 吴雅松[1] 倪勇[2] 王琛[2] 

机构地区：[1]厦门市第三医院麻醉科,福建厦门361100 [2]苏州大学附属第二医院麻醉科,江苏苏州215004

出　　处：《南昌大学学报（医学版）》2014年第4期24-26,共3页Journal of Nanchang University：Medical Sciences

基　　金：福建省卫生厅青年科研项目(2012291);厦门市卫生局资助项目

摘　　要：目的测定超声引导下锁骨上臂丛神经阻滞罗哌卡因的半数有效浓度（EC50）。方法选择择期行手或前臂手术患者40例（ASAⅠ—Ⅱ级）,采用超声引导下锁骨上臂从神经阻滞两点注射法注入罗哌卡因30mL,罗哌卡因的浓度（质量百分比）分别由低到高设为0.15%、0.20%、0.25%、0.30%和0.35%,初始浓度0.25%,间隔浓度为0.05%,注药30min后切皮时,视觉模拟评分（VAS）〉3分,改为全身麻醉下完成手术以及下一例采用高一级浓度。若VAS≤3分,则下一例采用低一级浓度。采用Probit法计算超声引导下锁骨上臂丛神经阻滞罗哌卡因的EC50及其95%可信区间（CI）。结果超声引导下罗哌卡因臂丛神经阻滞的EC50为0.243%,其95%CI为0.219%-0.266%。结论超声引导下罗哌卡因臂丛神经阻滞的EC50为0.243%。Objective To determine the median effective concentration（EC50） of ropivacaine for ultrasound-guided supraclavicular brachial plexus block. Methods Forty ASA Ⅰ or Ⅱ patients scheduled for hand or forearm surgery were given double point injection with 30 mL ropivacaine for ultrasound-guided supraclavicular brachial plexus block. The ropivacaine was injected at concentrations of 0.15%,0. 20%,0. 25%,0. 30% and 0.35%. The initial concentration was 0.25% and the concentration interval was 0.05 %. The anesthetic efficacy was assessed with visual ana- logue scale（VAS） 30 minutes after ropivacaine injection. General anesthesia was performed in pa- tients with VAS score greater than 3 and the next case was given higher concentration of ropivacaine. If VAS score was less than 3, the next case was given lower concentration of ropivacaine. The EC50 of ropivacaine for ultrasound-guided supraclavicular brachial plexus block and the 95 % confidence interval were calculated using probit analysis. Results The EC50 of ropivaeaine for trasound-guided supraclavicular brachial plexus block was 0,243 % and the 95% confidence int vaI ranged from 0. 219% to 0. 266%. Conclusion The EC50 of ropivaeaine was 0. 243% for ult sound-guided supraclavieular brachial plexus block.

关 键 词：超声检查 臂丛 神经传导阻滞 罗哌卡因 半数有效浓度 

分 类 号：R614.4[医药卫生—麻醉学]