超声引导下罗哌卡因股神经阻滞感觉运动分离的半数有效浓度  

Median effective concentration of ropivacaine producing sensory-motor separation when used for femoral nerve block performed under ultrasound guidance

作　　者：彭丽 张琦[2] 张亚辉[3] 朱炼[4] 侯志勇[4] 邵德成[5] 王秋筠[1] Peng Li;Zhang Qi;Zhang Yahui;Zhu Lian;Hou Zhiyong;Shao Decheng;Wang Qiujun(Department of Anesthesiology,Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Department of Anesthesiology,Hebei Children′s Hospital Affiliated to Hebei Medical University,Shijia-zhuang 050030,China;Department of Nursing,Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Center of Emergency and Trauma,Third Hospital of Hebei Medical University,Shijia-zhuang 050051,China;Department of Sport Medicine,Third Hospital of Hebei Medical University,Shijia-zhuang 050051,China)

机构地区：[1]河北医科大学第三医院麻醉科,石家庄050051 [2]河北医科大学附属河北省儿童医院麻醉科,石家庄050030 [3]河北医科大学第三医院护理部,石家庄050051 [4]河北医科大学第三医院创伤与急救中心,石家庄050051 [5]河北医科大学第三医院运动医学科,石家庄050051

出　　处：《中华麻醉学杂志》2020年第4期455-457,共3页Chinese Journal of Anesthesiology

基　　金：河北省政府资助专科能力建设和专科带头人培养项目。

摘　　要：目的确定超声引导下罗哌卡因股神经阻滞感觉运动分离的半数有效浓度。方法择期全麻下膝关节镜手术患者,年龄18~64岁,BMI 18~30 kg/m2,性别不限,ASA分级Ⅰ-Ⅲ级。超声引导下行股神经阻滞,定位成功后注入罗哌卡因22 ml,初始浓度为0.50%,相邻浓度比值为1.1,阳性反应为感觉阻滞,运动未阻滞;阴性反应为感觉和运动均阻滞,若出现阴性反应,则下一例患者采用低一级浓度,若出现阳性反应,下一例患者采用高一级浓度。采用probit法计算超声引导下罗哌卡因股神经阻滞感觉运动分离的半数有效浓度及其95%可信区间。结果超声引导下罗哌卡因股神经阻滞感觉运动分离的半数有效浓度为0.186%,95%可信区间为0.155%~0.205%。结论超声引导下罗哌卡因股神经阻滞感觉运动分离的半数有效浓度为0.186%。Objective To determine the median effective concentration(EC50)of ropivacaine producing sensory-motor separation when used for femoral nerve block performed under ultrasound guidance.Methods American Society of Anesthesiologists physical statusⅠ-Ⅲpatients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,scheduled for elective arthroscopic knee surgery under general anesthesia,were enrolled in this study.Femoral nerve block was performed under ultrasound guidance.After successful location,ropivacaine 22 ml was injected with the initial concentration of 0.50%,and the ratio between the two consecutive concentrations was 1.1.The EC50 of ropivacaine was determined by up-and-down sequential method.The positive response was considered as sensory block without motor block.The negative response was considered as sensory and motor block.When a negative response was found,the concentration was decreased in the next patient.When a positive response occurred,the concentration was increased in the next patient.Probit analysis was used to calculate the EC50 and 95%confidence interval of ropivacaine producing sensory-motor separation when used for femoral nerve block which was performed under ultrasound guidance.Results The EC50 of ropivacaine producing sensory-motor separation was 0.186%,and the 95%confidence interval was 0.155%-0.205%when used for ultrasound-guided femoral nerve block.Conclusion The EC50 of ropivacaine producing sensory-motor separation is 0.186%when used for femoral nerve block performed under ultrasound guidance.

关 键 词：酰胺类 股神经 神经传导阻滞 剂量效应关系 药物 超声检查 

分 类 号：R614[医药卫生—麻醉学]