昂丹司琼对罗哌卡因蛛网膜下腔阻滞效能的影响  

Effect of ondansetron on subarachnoid block by intrathecal injection of ropivacaine

作　　者：徐涛[1] 王佳[1] 王庚[1] 

机构地区：[1]积水潭医院麻醉科,北京100035

出　　处：《上海医学》2015年第2期100-102,共3页Shanghai Medical Journal

摘　　要：目的观察昂丹司琼是否对罗哌卡因蛛网膜下腔阻滞的效能产生影响。方法随机选取择期行下肢手术的患者44例,将其随机分入昂丹司琼组和对照组,每组22例。昂丹司琼组患者于麻醉前15min静脉滴注昂丹司琼4mg,对照组患者则未予昂丹司琼。所有患者均行罗哌卡因蛛网膜下腔阻滞,有效标准：1蛛网膜下腔阻滞后20min感觉阻滞平面（针刺疼痛消失法）至少达到T12水平;2运动阻滞以蛛网膜下腔阻滞后20min双下肢阻滞达到Bromage Scale评分≥2分（0分为髋、膝、踝关节均可正常运动;1分为不能抬腿,但可以活动膝和踝关节;2分为不能活动膝关节,但可以活动踝关节;3分为髋、膝、踝关节均不能运动）;3蛛网膜下腔阻滞后≥1h,硬脊膜外腔不再追加注射局部麻醉药物直至手术结束。根据序贯法公式计算两组患者罗哌卡因的半数有效量（ED50）及其95%CI。结果昂丹司琼组和对照组罗哌卡因的ED50及其95%CI分别为11.42（11.02～11.85）和11.32（10.92～11.80）mg,两组间差异无统计学意义（P〉0.05）。结论昂丹司琼对罗哌卡因蛛网膜下腔阻滞的效能无影响。Objective To evaluate the effect of ondansetron on subarachnoid block by intrathecal injection of ropivacaine. Methods Forty-four patients scheduled for surgical treatment of lower limb were randomly divided into ondansetron group and control group （n = 22）. Intravenous ondansetron （4 mg） was given for ondansetron group 15 min before spinal anaesthesia. Then all patients received subarachnoid block by intrathecal injection of ropivacaine. The criteria of effective spinal anesthesia was defined as.. （1） a bilateral loss of pinprick sensation at least at T12 20 min after block; （2） adequate motor block for knee arthroscopy （modified Bromage＇s score〉j2） （3） without epidural requirement at least 60 min after intrathecal injection. The dose of injection was determined by up-and-down method and the value of median effective dose （ED50） was calculated. Results The EDs0 was 11.42 （95% CI = 11.02 - 11.85） in the ondansetron group and 11.32 （95% CI = 10.92 - 11.80） in the control group. There was no significant difference in the EDs0 between the two groups （P〉0.05）. Conclusion Ondansetron dose not influence subarachnoid block by intrathecal injection of ropivacaine.

关 键 词：昂丹司琼 罗哌卡因 半数有效量 

分 类 号：R614[医药卫生—麻醉学]