右美托咪定对小儿骶管阻滞时罗哌卡因半数有效浓度的影响  

Effects of dexmedetomidine on medium effective concentration of ropivacaine for caudal block in children

作　　者：王文凯 刘煌 叶露 

机构地区：[1]惠州市第一妇幼保健院麻醉科,广东惠州516007

出　　处：《中国新药与临床杂志》2016年第3期194-197,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的研究右美托咪定对小儿罗哌卡因骶管阻滞半数有效浓度(EC50)的影响。方法选择拟行择期腹股沟斜疝修补手术的患儿80例,ASAⅠ~Ⅱ级,年龄1~6岁,体重低于标准体重的150%。将患儿随机分成两组,每组40例。对照组骶管阻滞时仅使用罗哌卡因,右美托咪定组骶管阻滞时使用罗哌卡因和右美托咪定1μg·kg-1的混合液,局麻药的容量均为1 m L·kg^(-1)。罗哌卡因的初始浓度为0.2%,相邻浓度比值为1.2,根据阻滞是否有效决定下一例浓度。采用Dixon-Massey序贯法计算罗哌卡因小儿骶管阻滞EC50及其95%可信区间(CI)。结果对照组罗哌卡因小儿骶管阻滞EC50为0.171%(95%CI:0.165%~0.178%),右美托咪定组为0.133%(95%CI:0.124%~0.148%),低于对照组,差异显著(P<0.05)。结论混合使用右美托咪定1μg·kg-1能明显降低小儿罗哌卡因骶管阻滞的EC50。AIM To investigate the effect of dexmedetomidine on the medium effective concentration （ECs0） of ropivacaine for caudal block in children. METHODS Eighty ASA physical status Ⅰ- Ⅱ children, 1 - 6 years, weight ≤150% standard weight, scheduled for inguinal hernia repair under caudal block, were included in this study. All children were randomly divided into control group or dexmedetomidine group with 40 in each. Caudal block was performed using only ropivacaine in the control group. The mixture of ropivacaine and dexmedetomidine 1 μg .kg-1 was injected for the block in the dexmedetomidine group. The volume of local anesthetics was 1 mL. kg-1. The initial concentration of ropivacaine was 0.2% and the ratio between the two successive concentrations was 1.2. If the block was effective, the next child received a lower dose of ropivacaine, or if ineffective, a higher dose was given in the next child. The EC50 and 95%confidence interval （CI） of ropivacaine were determined using the Dixon-Massey method. RESULTS The ECs0 （95%CI） of ropivacaine was 0.171% （0.165% - 0.178%） in the control group and the EC50（95%CI） of ropivacaine was 0.133% （0.124% -0.148% ） in the dexmedetomidine group. The EC50 of ropivacaine was significantly decreased in the dexmede-tomidine group compared with that in the control group （P 〈 0.05）. CONCLUSION Addition of dexmedetomidine 1 μg. kg-1 to local anesthetics can significantly decrease the EC50 of ropivacaine for caudal block in children.

关 键 词：右美托咪定 罗哌卡因 儿童 骶管阻滞 半数有效浓度 

分 类 号：R971[医药卫生—药品]