CAJ | 학술논문

目的：探讨重比重、等比重、轻比重罗哌卡因在肛肠手术腰-硬联合麻醉的半数有效剂量ED50。方法：择期肛肠手术患者60例，采用随机分为三组(n＝20)：轻比重罗哌卡因组(LR组)、等比重罗哌卡因组(ER组)和重比重罗哌卡因组(HR组)。用腰-硬联合麻醉(CSEA)技术，经L3～4间隙穿刺，三组第1例患者局部麻醉药的初始剂量均为6.67mg，LR组、ER组和HR组分别给予0.667%轻比重、0.667%等比重和0.667%重比重罗哌卡因1.0ml，根据腰-硬联合麻醉肛门松弛效果，按照Dixon法确定每组下一例患者麻醉剂量，麻醉剂量间隔为0.667mg。采用概率单位法计算不同比重罗哌卡因腰-硬联合麻醉ED50及其95%可信区间(CI)。结果：0.667%轻比重、0.667%等比重和0.667%重比重罗哌卡因的ED50分别为5.36mg(95% CI 4.70～8.12mg)、5.48mg(95% CI 4.78～8.26mg)和5.30mg(95%CI 4.69～8.04mg)，三者ED50比较无统计学意义(P>0.05)。结论：0.667%轻比重、0.667%等比重和0.667%重比重罗哌卡因的ED50分别为5.36mg、5.48mg和5.30mg，罗哌卡因比重因素对肛肠手术麻醉效果无影响。
목적：탐토중비중、등비중、경비중라고잡인재항장수술요-경연합마취적반수유효제량ED50。방법：택기항장수술환자60례，채용수궤분위삼조(n＝20)：경비중라고잡인조(LR조)、등비중라고잡인조(ER조)화중비중라고잡인조(HR조)。용요-경연합마취(CSEA)기술，경L3～4간극천자，삼조제1례환자국부마취약적초시제량균위6.67mg，LR조、ER조화HR조분별급여0.667%경비중、0.667%등비중화0.667%중비중라고잡인1.0ml，근거요-경연합마취항문송이효과，안조Dixon법학정매조하일례환자마취제량，마취제량간격위0.667mg。채용개솔단위법계산불동비중라고잡인요-경연합마취ED50급기95%가신구간(CI)。결과：0.667%경비중、0.667%등비중화0.667%중비중라고잡인적ED50분별위5.36mg(95% CI 4.70～8.12mg)、5.48mg(95% CI 4.78～8.26mg)화5.30mg(95%CI 4.69～8.04mg)，삼자ED50비교무통계학의의(P>0.05)。결론：0.667%경비중、0.667%등비중화0.667%중비중라고잡인적ED50분별위5.36mg、5.48mg화5.30mg，라고잡인비중인소대항장수술마취효과무영향。
To investigate the weight proportion,etc.,the proportion of hypobaric ropivacaine in spinal anesthesia for anorectal operation median effective dose of ED50.Methods: 60 patients undergoing anorectal operation,using randomly divided into 3 groups(n=20):hypobaric ropivacaine group (group LR),isobaric ropivacaine group (group ER) and hyperbaric ropivacaine group (group HR).With combined spinal epidural anesthesia (CSEA) technology, the L3~L4 gap puncture,initial dose of 3 group of ifrst patients with local anesthetics were 6.67mg,LR group, ER group and HR group were given 0.667% light speciifc gravity,0.667% speciifc gravity and 0.667% hyperbaric ropivacaine 1ml,according to the spinal anal relaxation effect according to determine patient doses,each one case of Dixon method,dose interval is 0.667mg. Calculation of different proportion of ropivacaine ED50 and 95% conifdence intervals by using a probit method (CI).Results:0.667% light speciifc gravity,0.667% speciifc gravity and 0.667% hyperbaric ropivacaine ED50 were 5.36mg (95% CI 4.70~8.12mg),5.48 mg (95% CI 4.78~8.26mg) and 5.30mg (95% CI 4.69~8.04mg),three ED50 were not significant(P>0.05). Conclusion:0.667% light specific gravity,0.667% specific gravity and 0.667% hyperbaric ropivacaine ED50 were 5.36mg,5.48mg and 5.30mg,ropivacaine proportion factor had no effect on anorectal operation anesthesia.