芬太尼对小剂量罗哌卡因腰麻ED_(50)的影响  

Effect of fentanyl on ropivacaine ED_(50) used for lumbar anesthesia in procedure for prolapse and hemorrhoids

作　　者：王静[1] 蔡靓羽[1] 徐敏逸[1] 周红梅[1] 倪平[1] 尹卫娟[1] WANG Jing CAI Liangyu XU Minyi et al(Department of Anesthesiology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214071, CHINA)

机构地区：[1]无锡市中医医院麻醉科,江苏省214071

出　　处：《江苏医药》2017年第12期871-873,共3页Jiangsu Medical Journal

基　　金：无锡市医院管理中心科研项目(YGZXM1556)

摘　　要：目的探讨芬太尼对罗哌卡因腰麻半数有效剂量(ED_(50))的影响。方法吻合器痔上黏膜环切术(PPH)成年男性患者40例,随机均分为两组。腰麻药物:FR组为芬太尼10μg+罗哌卡因+10%葡萄糖液1ml;R组为罗哌卡因+10%葡萄糖液1ml。均用脑脊液稀释麻醉药至3ml,以0.2ml/s推注药液。采用序贯法确定罗哌卡因腰麻ED_(50)剂量;记录BP、HR,评估麻醉效果、感觉阻滞平面和改良Bromage下肢运动功能评级。观察麻醉相关不良反应发生情况。结果两组麻醉满意,循环稳定。FR组满足PPH的罗哌卡因ED_(50)为4.23mg,95%CI(3.99~4.48mg);R组的罗哌卡因ED_(50)为5.07mg,95%CI(4.71~5.43mg)。FR组罗哌卡因ED_(50)低于R组(P<0.05)。结论复合芬太尼10μg能减少罗哌卡因腰麻的ED50剂量。Objective To investigate the effect of fentanyl on the half effective dose（ED50）of ropivacaine used for spinal anesthesia in procedure for prolapse and hemorrhoids（PPH）.Methods Forty adult male patients were equally randomized into two groups,who were undergoing PPH under spinal anesthesia with ropivacaine.Spinal anesthetics consisted of fentanyl 10μg＋ropivacaine＋10%glucose 1ml（group FR）or ropivacaine＋10%glucose 1ml（group R）,which was diluted with cerebral spinal fluid up to 3ml and injected in a speed of 0.2ml/s.The ED50 of ropivacaine spinal anesthesia was determined by sequential method.BP and HR were monitored,anesthesia efficacy,sensory block plane and modified Bromage grading of lower limb motor function were evaluated.Anesthesia-related adverse effects were observed.Results The anesthesia was satisfactory and circulation was stable in both groups.The ED50 of ropivacaine spinal anesthesia met the needs of PPH was 4.23mg[95%CI（3.99-4.48mg）]in group FR,which was significantly lower than 5.07mg[95%CI（4.71-5.43mg）]in group R（P〈0.05）.Conclusion Adding fentanyl 10μg can significantly reduce the ED50 of ropivacaine spinal anesthesia for PPH.

关 键 词：腰麻 罗哌卡因 半数有效剂量 芬太尼 痔上黏膜环切术 

分 类 号：R614[医药卫生—麻醉学]