腹式子宫切除术中0.6%甲磺酸罗哌卡因脊髓麻醉的有效剂量

发布时间：2017-12-26 19:30

本文关键词：腹式子宫切除术中0.6%甲磺酸罗哌卡因脊髓麻醉的有效剂量　出处：《中国现代医学杂志》2016年03期 　论文类型：期刊论文

【摘要】：目的观察研究0.6%甲磺酸罗哌卡因在腹式子宫切除术腰麻联合硬膜外麻醉中蛛网膜下腔阻滞的有效剂量。方法随机选取妇科腹式子宫切除术患者80例,按随机数字表法分为4组,每组20例。单因素设计,采用序贯试验的Robbins-Monro法,监测血压、心电图、术中恶心、呕吐,观察感觉神经和运动神经阻滞、术后并发症及追踪1个月后肝、肾功能是否发生变化,记录达到有效剂量标准、超过有效剂量标准、未达到有效剂量标准的情况,并据此分析研究。结果在腹式子宫切除术腰麻联合硬膜外麻醉中,应用0.6%甲磺酸罗哌卡因使蛛网膜下腔阻滞达到有效标准者的生命体征平稳,心电图未见明显变化,术中偶有恶心,无呕吐。其半数有效剂量(ED50)为15.33 mg,95%可信区间为13.56,16.76。结论 0.6%甲磺酸罗哌卡因可以安全有效地应用于腰麻联合硬膜外麻醉蛛网膜下腔阻滞,ED50为15.33 mg,无明显毒副作用,对循环影响较轻。
[Abstract]:Objective To observe and study the effective dose of 0.6% mesylate ropivacaine for subarachnoid block during abdominal anesthesia combined with epidural anesthesia for abdominal hysterectomy. Methods 80 cases of gynecologic abdominal hysterectomy were randomly selected and divided into 4 groups according to the random digital table method, with 20 cases in each group. The single factor design, Robbins-Monro method using sequential test, blood pressure, electrocardiogram, intraoperative nausea and vomiting, observation of the sensory nerve and motor nerve block, postoperative complications and follow-up 1 months after liver and kidney function is changed, the effective dose to record standard, more effective than did not reach the standard, the standard dose and effective dose and based on the analysis and research. Results in abdominal spinal hysterectomy, spinal epidural anesthesia, 0.6% methanesulfonic acid ropivacaine for subarachnoid block to achieve effective standards of vital signs were stable, ECG did not change significantly, intraoperative occasionally nausea and vomiting. The median effective dose (ED50) was 15.33 mg and the 95% confidence interval was 13.56,16.76. Conclusion 0.6% methanesulfonic acid ropivacaine can be safely and effectively applied to spinal anesthesia combined with epidural anesthesia for subarachnoid block, ED50 is 15.33 mg, has no obvious side effects, and has less effect on circulation.
【作者单位】：内蒙古科技大学包头医学院第一附属医院麻醉科;
【基金】：内蒙古自治区卫生和计划生育委员会资助项目(No:201302105)
【分类号】：R614.41
【正文快照】： 甲磺酸罗哌卡因是一新型酰胺类局部麻醉药,稳定性好,药代动力学与盐酸罗哌卡因相似[1],神经毒性较弱,已广泛应用于临床麻醉,推测其在蛛网膜下腔阻滞中可能对循环影响较小。国外文献未见甲磺酸罗哌卡因用于蛛网膜下腔的有关报道。汪俊芳等[2]报道大鼠蛛网膜下腔注射甲磺酸罗哌

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