实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2014年
5期
34-37
,共4页
傅志海%吴雅松%陈再治%崔晓%熊贤俊
傅誌海%吳雅鬆%陳再治%崔曉%熊賢俊
부지해%오아송%진재치%최효%웅현준
超声检查%臂丛%神经传导阻滞%罗哌卡因
超聲檢查%臂叢%神經傳導阻滯%囉哌卡因
초성검사%비총%신경전도조체%라고잡인
ultrasonography%brachial plexus%nerve block%ropivacaine
目的：测定超声引导下锁骨上臂丛神经阻滞0.375%盐酸罗哌卡因的半数有效剂量。方法选择择期行手或前臂手术的40例患者（ASA分级Ⅰ-Ⅱ级），采用超声引导下锁骨上臂丛神经阻滞两点注射法注入0.375%盐酸罗哌卡因，盐酸罗哌卡因的剂量分别由低到高设为12、14、16、18和20 mL ，初始剂量16 mL ，间隔剂量为2 mL ，注药30 min后切皮时，视觉模拟评分（VAS）＞3分，改为全身麻醉以及下一例采用高一级剂量。若VAS≤3分，则下一例采用低一级剂量。采用Probit法计算超声引导下锁骨上臂丛神经阻滞0.375%盐酸罗哌卡因的半数有效剂量及其95％可信区间（CI）。结果超声引导下锁骨上臂丛神经阻滞0.375%盐酸罗哌卡因的半数有效剂量为15.9 mL，95％CI为12.7～19.1 mL。结论正常成人超声引导下锁骨上臂丛神经阻滞0.375%盐酸罗哌卡因的半数有效剂量为15.9 mL。
目的：測定超聲引導下鎖骨上臂叢神經阻滯0.375%鹽痠囉哌卡因的半數有效劑量。方法選擇擇期行手或前臂手術的40例患者（ASA分級Ⅰ-Ⅱ級），採用超聲引導下鎖骨上臂叢神經阻滯兩點註射法註入0.375%鹽痠囉哌卡因，鹽痠囉哌卡因的劑量分彆由低到高設為12、14、16、18和20 mL ，初始劑量16 mL ，間隔劑量為2 mL ，註藥30 min後切皮時，視覺模擬評分（VAS）＞3分，改為全身痳醉以及下一例採用高一級劑量。若VAS≤3分，則下一例採用低一級劑量。採用Probit法計算超聲引導下鎖骨上臂叢神經阻滯0.375%鹽痠囉哌卡因的半數有效劑量及其95％可信區間（CI）。結果超聲引導下鎖骨上臂叢神經阻滯0.375%鹽痠囉哌卡因的半數有效劑量為15.9 mL，95％CI為12.7～19.1 mL。結論正常成人超聲引導下鎖骨上臂叢神經阻滯0.375%鹽痠囉哌卡因的半數有效劑量為15.9 mL。
목적：측정초성인도하쇄골상비총신경조체0.375%염산라고잡인적반수유효제량。방법선택택기행수혹전비수술적40례환자（ASA분급Ⅰ-Ⅱ급），채용초성인도하쇄골상비총신경조체량점주사법주입0.375%염산라고잡인，염산라고잡인적제량분별유저도고설위12、14、16、18화20 mL ，초시제량16 mL ，간격제량위2 mL ，주약30 min후절피시，시각모의평분（VAS）＞3분，개위전신마취이급하일례채용고일급제량。약VAS≤3분，칙하일례채용저일급제량。채용Probit법계산초성인도하쇄골상비총신경조체0.375%염산라고잡인적반수유효제량급기95％가신구간（CI）。결과초성인도하쇄골상비총신경조체0.375%염산라고잡인적반수유효제량위15.9 mL，95％CI위12.7～19.1 mL。결론정상성인초성인도하쇄골상비총신경조체0.375%염산라고잡인적반수유효제량위15.9 mL。
Objective To determine the median effective dosage of 0.375% ropivacaine in ultrasound-guided supraclavicular brachial plexus block.Methods Forty ASAⅠ-Ⅱpatients scheduled for hand or forearm surgery were given two-point injection with 0.375% ropivacaine at doses of 12, 14, 16,18 and 20 mL for ultrasound-guided supraclavicular brachial plexus block. The initial concentration was set at 16 mL. Dosage interval was 2 mL.The anesthetic efficacy was assessed with visual analogue scale (VAS) 30 minutes after injection. If VAS score was greater than 3,general anesthesia was performed and the next case was given a higher dose of ropivacaine. If VAS score was less than or equal to 3,the next case was given a lower dose of ropivacaine. The median effective dosage of 0.375%ropivacaine in ultrasound-guided supraclavicular brachial plexus block and 95% confidence interval were calculated using Probit analysis. Results The median effective dosage of 0.375% ropivacaine in ultrasound-guided supraclavicular brachial plexus block was 15.9 mL,and the 95% confidence interval ranged from 12.7 to 19.1 mL. Conclusion The median effective dosage of 0.375% ropivacaine in ultrasound-guided supraclavicular brachial plexus block was 15.9 mL in normal adults.
