临床麻醉学杂志
臨床痳醉學雜誌
림상마취학잡지
THE JOURNAL OF CLINICAL ANESTHESIOLOGY
2014年
6期
581-583
,共3页
路强%丁路%韩正飞%杨志珂
路彊%丁路%韓正飛%楊誌珂
로강%정로%한정비%양지가
腰麻%舒芬太尼%罗哌卡因%半数有效量
腰痳%舒芬太尼%囉哌卡因%半數有效量
요마%서분태니%라고잡인%반수유효량
Spinal anesthesia%Sufentanil%Ropivacaine%Median effective concentration
目的：观察舒芬太尼联合罗哌卡因行蛛网膜下腔阻滞用于老年患者手术的效果,探讨舒芬太尼对老年患者蛛网膜下腔阻滞时罗哌卡因 ED50的影响。方法择期行下肢或会阴部手术的老年患者48例,ASA Ⅰ~Ⅲ级,随机分为舒芬太尼组(S 组)和对照组(C 组)。选择 L3~4椎间隙穿刺,S 组为舒芬太尼和0.5%罗哌卡因,其中舒芬太尼固定为5.0μg,C 组为0.5%罗哌卡因,根据预实验结果及序贯法原则,S 组第1例患者罗哌卡因给药剂量为8.0 mg,C 组第1例患者罗哌卡因给药剂量为9.0 mg。此后如前一例患者符合有效标准则后一例患者给药剂量下调1.0 mg,反之则上调1.0 mg。ED50采用 Dixon-Massey 序贯法计算。结果舒芬太尼联合罗哌卡因用于老年患者腰麻下肢或会阴部手术的 ED50为6.40 mg (95%CI：5.98~6.80 mg),单纯罗哌卡因的 ED50为8.42 mg (95%CI：7.79~9.03 mg)。与给药前比较,C 组给药后3、6、15 min 后 MAP 明显降低,且明显低于 S组(P <0.01),但均在正常范围内。结论老年患者蛛网膜下腔阻滞复合5.0μg 舒芬太尼时,罗哌卡因 ED50降低。
目的：觀察舒芬太尼聯閤囉哌卡因行蛛網膜下腔阻滯用于老年患者手術的效果,探討舒芬太尼對老年患者蛛網膜下腔阻滯時囉哌卡因 ED50的影響。方法擇期行下肢或會陰部手術的老年患者48例,ASA Ⅰ~Ⅲ級,隨機分為舒芬太尼組(S 組)和對照組(C 組)。選擇 L3~4椎間隙穿刺,S 組為舒芬太尼和0.5%囉哌卡因,其中舒芬太尼固定為5.0μg,C 組為0.5%囉哌卡因,根據預實驗結果及序貫法原則,S 組第1例患者囉哌卡因給藥劑量為8.0 mg,C 組第1例患者囉哌卡因給藥劑量為9.0 mg。此後如前一例患者符閤有效標準則後一例患者給藥劑量下調1.0 mg,反之則上調1.0 mg。ED50採用 Dixon-Massey 序貫法計算。結果舒芬太尼聯閤囉哌卡因用于老年患者腰痳下肢或會陰部手術的 ED50為6.40 mg (95%CI：5.98~6.80 mg),單純囉哌卡因的 ED50為8.42 mg (95%CI：7.79~9.03 mg)。與給藥前比較,C 組給藥後3、6、15 min 後 MAP 明顯降低,且明顯低于 S組(P <0.01),但均在正常範圍內。結論老年患者蛛網膜下腔阻滯複閤5.0μg 舒芬太尼時,囉哌卡因 ED50降低。
목적：관찰서분태니연합라고잡인행주망막하강조체용우노년환자수술적효과,탐토서분태니대노년환자주망막하강조체시라고잡인 ED50적영향。방법택기행하지혹회음부수술적노년환자48례,ASA Ⅰ~Ⅲ급,수궤분위서분태니조(S 조)화대조조(C 조)。선택 L3~4추간극천자,S 조위서분태니화0.5%라고잡인,기중서분태니고정위5.0μg,C 조위0.5%라고잡인,근거예실험결과급서관법원칙,S 조제1례환자라고잡인급약제량위8.0 mg,C 조제1례환자라고잡인급약제량위9.0 mg。차후여전일례환자부합유효표준칙후일례환자급약제량하조1.0 mg,반지칙상조1.0 mg。ED50채용 Dixon-Massey 서관법계산。결과서분태니연합라고잡인용우노년환자요마하지혹회음부수술적 ED50위6.40 mg (95%CI：5.98~6.80 mg),단순라고잡인적 ED50위8.42 mg (95%CI：7.79~9.03 mg)。여급약전비교,C 조급약후3、6、15 min 후 MAP 명현강저,차명현저우 S조(P <0.01),단균재정상범위내。결론노년환자주망막하강조체복합5.0μg 서분태니시,라고잡인 ED50강저。
Objective To investigate the effects of median effective dose (ED50 )of ropivacaine combined with sufentanil for spinal anesthesia in elderly patients.Methods Forty-eight elderly patients (ASAⅠ-Ⅲ)scheduled for elective lower limb or perineum operation under spinal anesthesia were enrolled in this study.All patients were randomly divided into two groups:control group (group C)and sufentanil group (group S).L3-4 intervertebral puncture was selected for all patients.Anesthetic solution in group C was 0.5% ropivacaine,in group S was 0.5% ropivacaine and sufentanil,which was fixed at 5.0 μg,based on the experimental results and sequential principle.The ropivacaine dose of first patient in the control group was 9.0 mg,and in sufentanil group was 8.0 mg,followed by reducing the dose of ropivacaine,each time 1.0 mg.If the patient appeared invalid standards response,the previous one was selected as the first case. ED50 was determined by Dixon??s sequential method.Results The ED50 of sufentanil combined with ropiva-caine for spinal anesthesia in elderly patients with lower extremity or perineal surgery was 6.40 mg (95%CI:5.98-6.80 mg),ED50 of only ropivacaine was 8.42 mg (95% CI:7.79-9.03 mg).Compared with pre-dose,MAP at 3,6,15 min after treated in group C were decreased,and lower than those in group S (P <0.01).Conclusion Combined with 5.0 μg sufentanil in spinal anesthesia for lower limb or perineal surgery elderly,median effective dose of ropivacaine is reduced.
