超声引导下连续胫神经阻滞时0.2%罗哌卡因半数有效背景量  

Median effective volume 0.2% ropivacaine for continuous tibial nerve block guided by ultrasound

作　　者：伊军[1] 林惠华[1] 杨庆国[1] 

机构地区：[1]北京积水潭医院麻醉科,100035

出　　处：《临床麻醉学杂志》2015年第8期753-755,共3页Journal of Clinical Anesthesiology

摘　　要：目的 测定超声引导下0.2%罗哌卡因连续胫神经阻滞应用于术后镇痛的半数有效背景量（ED50）。方法 选择22例ASAⅠ或Ⅱ级择期行跟骨手术患者,采用超声引导技术行腘窝后入路胫神经阻滞。定位成功后置入连续刺激导管,采用序贯法给药,0.2%罗哌卡因起始背景量为5ml/h,如术后24、48h患者胫神经区域感觉完全阻滞,则下一例背景量减少0.5ml/h;如阻滞效果不完善,则下一例背景量增加0.5ml/h。结果 0.2%罗哌卡因用于超声引导下后入路连续胫神经阻滞镇痛时,ED50为2.6ml/h（95%CI：2.2~3.0ml/h）,ED95为3.2ml/h（95%CI：2.9~5.8 ml/h）。结论 0.2%罗哌卡因用于超声引导下腘窝后入路连续胫神经阻滞镇痛时,背景量ED50为2.6ml/h。Objective To determine median effective volume （ED50） of 0. 2% ropivacaine for ultrasound-guided continuous tibial nerve block. Methods Twenty two ASA Ⅰ or Ⅱ patients undergoing calcaneus surgery received popliteal fossa posterior tibial nerve block using ultrasound guidance. The volume of the injected solution was varied for consecutive patients using the up-and-down staircase method according to the response of the previous patient （initial volume： 5 Inl/h; up-and-down steps： 0.5 ml/h）. We recorded the blockade situation of sensory at 24 hs and 48 hs after the placement of the stimulation catheter. The study was ended when we got six reverse sequences. Results The ED50 of 0. 2% ropivacaine resulting in complete block of the tibial nerve was 2.6 ml/h （95%CI.-2.2-3.0 ml/h）. El）50 of 0.2 % ropivacaine resulting in complete block of the tibial nerve was 3.2 ml/h （95%CI：2.9-5.8 ml/h）. Conclusion The ED50 of 0.2% ropivacaine for ultrasound-guided popliteal fossa posterior continuous tibial nerve block was 2.6 ml/h.

关 键 词：腘窝后入路胫神经阻滞 超声引导 罗哌卡因 剂量-效应关系 

分 类 号：R614[医药卫生—麻醉学]