0.5%罗哌卡因用于超声引导下腘窝上坐骨神经阻滞的ED_(95)  

95% effective dosage of 0.5% ropivacaine for ultrasound guided popliteal sciatic nerve block

作　　者：谢亚明[1] 徐杨[1] 吴军珍[1] 赵达强[1] 

机构地区：[1]上海交通大学附属第六人民医院麻醉科,200233

出　　处：《临床麻醉学杂志》2015年第2期134-136,共3页Journal of Clinical Anesthesiology

摘　　要：目的测定0.5%罗哌卡因用于超声引导下腘窝上坐骨神经阻滞的95%有效剂量（ED95）。方法选择拟行踝关节手术的患者24例,男13例,女11例,年龄20~60岁,BMI 20~30kg/m2,ASAⅠ或Ⅱ级。在超声引导下定位腘窝上坐骨神经,测量坐骨神经的横截面积后,根据面积注入0.5%罗哌卡因,罗哌卡因的剂量按Dixon上下序贯法确定,起始剂量为0.2ml/mm2,若阻滞有效,则下一例患者减少0.02ml/mm2;反之,下一例患者增加0.02ml/mm2。阻滞有效标准为神经阻滞45min后胫神经、腓浅神经、腓深神经、腓肠神经皮肤分布区无痛觉。计算ED95及其95%可信区间（CI）。结果超声引导下腘窝上坐骨神经阻滞,0.5%罗哌卡因的ED95为0.14ml/mm2,95%CI为0.12~0.27ml/mm2。结论 0.5%罗哌卡因用于超声引导下腘窝上坐骨神经阻滞的ED95为0.14ml/mm2。Objective To determine the 95% effective dosage of 0. 5% ropivacaine for ultrasound guided popliteal sciatic nerve block undergoing ankle surgery. Methods Twenty four patients aged 20-60 years old including male 13 and female 11 with BMI 20-30 kg/m2 and ASA I or Ⅱ were scheduled to receive ankle surgery. The volume of 0. 5% ropivacaine injected in each patient was based on cross-sectional nerve area by Dixons up and down method. The initial volume was 0.2 ml/mm2 cross-sectional nerve area, and each time the volume increased by 0. 02 ml/mm2 cross-sectional nerve area if the block failed. The volume of ropivaeaine was reduced by 0. 02 ml/mm2 if block succeeded. The definition of a successful block was tested with a pinprick in areas of tibial nerve, superficial peroneal nerve, deep peroneal nerve, sural nerve 45 min after block performed. The ED35 and 95% infidence interval of 0. 5% ropivacaine were calculated. Results ED95 of 0. 5% ropivaeaine for ultrasound guided popliteal sciatic nerve block was 0. 14 ml/mm2, 95% confidence interval was 0. 12-0. 27 ml/mm2. Conclusion ED95 of 0. 5% ropivaeaine for ultrasound guided popliteal sciatic nerve block is 0. 14 ml/mm2.

关 键 词：超声引导 坐骨神经 罗哌卡因 95%有效剂量 

分 类 号：R614[医药卫生—麻醉学]