超声引导下颈7平面0.15%罗哌卡因星状神经节阻滞的有效剂量分析  

Effective dosage analysis of ultrasound-guided stellate ganglion block with 0.15% ropivacaine at C7 level

作　　者：王武涛 赵俊莺 韩彬 何爱萍 舒雅 王莉 WANG Wutao;ZHAO Junying;HAN Bin;HE Aiping;SHU Ya;Wang Li(Department of Anesthesiology,the First Affiliated Hospital of Xi’an Medical University,Xi’an 710077,China)

机构地区：[1]西安医学院第一附属医院西安医学院全科医学院麻醉科,西安市710077

出　　处：《临床超声医学杂志》2018年第4期264-266,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声引导下颈7平面0.15%罗哌卡因星状神经节阻滞的95%有效剂量(ED95)。方法选取因失眠需行星状神经节阻滞的患者20例,于超声引导下在颈7平面采用短轴平面内技术将药物注射在颈长肌和头长肌之间的颈横筋膜下,药物选择浓度为0.15%罗哌卡因注射液,药物剂量按Dixon序贯法确定,初始剂量为4.0 ml,若阻滞成功,在下一例患者阻滞时减少0.4 ml,反之在下一例患者阻滞时增加0.4 ml;阻滞有效的标准是出现Horner’s综合征,即上睑下垂,并计算ED95及95%可信区间。结果 20例患者阻滞有效14例,阻滞无效6例。超声引导下颈7平面0.15%罗哌卡因星状神经节阻滞的ED95为1.6 ml,95%可信区间为1.17~2.03。结论超声引导下颈7平面0.15%罗哌卡因星状神经节阻滞的ED95为1.6 ml。Objective To investigate the 95% effective dosage(ED95) of ultrasound-guided stellate ganglion block(SGB) with 0.15% ropivacaine at C7 level. Methods Twenty patients with insomnia requiring SGB were selected. Under ultrasound-guided,the transverse short-axis view of the neck at the C7 level was used to inject ropivacaine under the cervical transverse fascia between musculus longus colli and longus capitis. The concentration of injected ropivacaine was 0.15%,the drug dosage was determined by the sequential Dixon method with an initial dosage of 4.0 ml. If the block was successful,the drug dosage in the next patient was decreased by 0.4 ml,otherwise the block dosage was increased by 0.4 ml in the next patient. A successful block was confirmed by the onset of Horner’s syndrome with ptosis of the upper eyelid. The ED95 and 95% confidence interval were calculated. Results A total of 14 cases were effective in block and 6 cases were ineffective in 20 cases. During ultrasound-guided SGB at C7 level with 0.15% ropivacaine,the ED95 was 1.6 ml and the 95% confidence interval was 1.17~2.03. Conclusion ED95 of ultrasound-guided SGB with 0.15% ropivacaine at C7 level is 1.6 ml.

关 键 词：超声引导 星状神经节阻滞 罗哌卡因 95%有效剂量 

分 类 号：R614.4[医药卫生—麻醉学] R445.1[医药卫生—外科学]