舒芬太尼对老年患者硬膜外阻滞时罗哌卡因半数有效浓度的影响

发布时间：2018-03-27 22:07

本文选题：罗哌卡因　切入点：舒芬太尼　出处：《中国新药与临床杂志》2015年04期

【摘要】：目的研究舒芬太尼对老年患者经尿道前列腺切除(TURP)术硬膜外阻滞时罗哌卡因半数有效浓度(EC50)的影响。方法采用随机、双盲、前瞻性研究。择期行TURP手术老年患者66例,随机分为两组,每组33例。单药组仅予罗哌卡因,联合用药组复合舒芬太尼5μg。两组第1例患者罗哌卡因浓度均为0.3%,相邻浓度差为0.025%,以双侧感觉阻滞达到T10为有效指标。根据序贯法调整罗哌卡因浓度,应用Dixon和Massey法计算罗哌卡因EC50。观察两组生命体征、感觉阻滞起效时间等,并记录不良反应。结果共完成58例,每组29例。两组硬膜外给药后各观察时点心率、平均动脉压及手术时间比较均无显著差异(P0.05)。单药组罗哌卡因EC50为0.186%(95%CI:0.173%~0.200%),高于联合用药组[0.136%,95%CI:0.127%~0.144%],组间差异非常显著(P0.01)。两组运动阻滞Bromage评分以及感觉阻滞起效时间均无显著差异(P0.05)。两组均无严重不良反应发生,硬膜外注药后5 min单药组和联合用药组分别发生低血压2例和1例。结论舒芬太尼复合罗哌卡因硬膜外麻醉用于老年患者行TURP术时,可降低罗哌卡因的EC50,复合舒芬太尼硬膜外阻滞时需降低罗哌卡因的浓度。
[Abstract]:Objective to study the effect of sufentanil on ropivacaine EC50 during epidural transurethral prostatectomy (TURP) in elderly patients. They were randomly divided into two groups, 33 cases in each group, and only ropivacaine was given to the single drug group. The concentration of ropivacaine in the first case of both groups was 0.3, the difference of adjacent concentration was 0.025. The effective index of bilateral sensory block was T10, and the ropivacaine concentration was adjusted according to the sequential method. Ropivacaine EC50 was calculated by Dixon and Massey. Vital signs and onset time of sensory block were observed and adverse reactions were recorded. Results there were 58 cases in each group, 29 cases in each group. Heart rate was observed at each time point after epidural administration of ropivacaine in both groups. There was no significant difference in mean arterial pressure and operative time (P 0.05). The EC50 of ropivacaine in single drug group was 0.186 ~ 95CI: 0.173% 0.200, which was higher than that in combination group [0.13695 CI: 0.127 and 0.144%]. There was no significant difference between the two groups in the Bromage score of motor block and the onset time of sensory block. There was no significant difference between the two groups in the Bromage score of motor block and the onset time of sensory block. No serious adverse reactions occurred in both groups. Hypotension occurred in 2 cases and 1 case in single drug group and combined group 5 min after epidural injection. Conclusion Sufentanil combined with ropivacaine epidural anesthesia can be used in elderly patients undergoing TURP. The EC50 of ropivacaine was decreased, and the concentration of ropivacaine was decreased when combined with sufentanil epidural block.
【作者单位】：绍兴市人民医院麻醉科;绍兴市人民医院医学研究中心;
【基金】：浙江省钱江人才计划项目(2012R10033)
【分类号】：R614

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