罗哌卡因在小儿上肢骨折手术中的半数有效浓度研究  

Study on the Median Effective Concentration of Ropivacaine in Pediatric Upper Limb Fracture Surgery

作　　者：宋晓波 Song Xiaobo(Department of Anesthesiology,Beijing Jishuitan Hospital Guizhou Hospital,Guiyang,Guizhou 550000)

机构地区：[1]北京积水潭医院贵州医院麻醉科,贵州贵阳550000

出　　处：《科技与健康》2025年第2期53-56,共4页Technology and Health

摘　　要：探究罗哌卡因在小儿上肢骨折手术中的半数有效浓度(EC50)。选取2022年1月—2024年5月北京积水潭医院贵州医院收治的110例3~6岁患儿为研究对象,所有患儿均接受上肢骨折手术,ASA分级为Ⅰ~Ⅱ级。麻醉方案选择中,均应用超声引导下行腋路臂丛神经阻滞,完成定位后,应用1 mL/kg的罗哌卡因。通过Dixon序贯法完成试验,所有患儿的罗哌卡因起始浓度设定为0.2%,在试验中进行患儿切皮前与切皮后的对比,若1例患儿切皮之后发生体动反应,或者平均动脉压和(或)心率比之前上升超过20%,则将下1例患儿设定为高一级浓度,试验剂量的浓度序列级别为0.025%。完成数据收集后,应用Probit概率单位回归法,计算罗哌卡因EC50及其95%CI。研究发现,在上肢骨折手术中,通过Dixon序贯法计算后,得出罗哌卡因的EC50为0.119%。To explore the median effective concentration(EC50)of ropivacaine in pediatric upper limb fracture surgery.A total of 110 children aged 3~6 years old,who were admitted to Beijing Jishuitan Hospital Guizhou Hospital from January 2022 to May 2024,were selected as the research subjects.All children underwent upper limb fracture surgery,and their American Society of Anesthesiologists(ASA)physical status classification was grade I~II.In the selection of anesthesia regimens,axillary brachial plexus block under ultrasound guidance was applied to all children.After positioning,1 mL/kg of ropivacaine was used.The experiment was completed by the Dixon sequential method.The initial concentration of ropivacaine for all children was set at 0.2%.In the experiment,the situation before and after skin incision of the children was compared.If a child had a body movement reaction after skin incision,or the mean arterial pressure and/or heart rate increased by more than 20%compared with before,the concentration for the next child was set at the next higher level.The concentration sequence level of the test dose was 0.025%.After data collection,the Probit regression method was used to calculate the EC50 of ropivacaine and its 95%confidence interval(CI).The study found that in upper limb fracture surgery,after calculation by the Dixon sequential method,the EC50 of ropivacaine was 0.119%.

关 键 词：罗哌卡因 小儿 上肢骨折 手术 半数有效浓度 

分 类 号：R726.1[医药卫生—儿科]