芬太尼局部用药对罗哌卡因臂丛神经阻滞最低有效浓度的影响

发布时间：2018-07-05 03:52

  本文选题：芬太尼 + 罗哌卡因　； 参考：《浙江医学》2016年24期

【摘要】：目的研究芬太尼局部用药对罗哌卡因臂丛神经阻滞最低有效浓度的影响。方法将100例择期手术患者按随机数字表法分为罗哌卡因组(R组)和罗哌卡因复合芬太尼组(RF组),各50例。两组患者均在超声引导下行锁骨上臂丛神经阻滞,R组注射30ml的罗哌卡因,RF组注射罗哌卡因与0.05mg芬太尼混合液,罗哌卡因以0.30%为起始浓度,采用序贯法,相邻浓度比值为1.2。注药后30min内通过视觉模拟法评分(VAS)评定麻醉是否有效,同时记录围麻醉期相关并发症。采用Dixon-Ma s s e y法计算罗哌卡因的半数有效浓度(EC_(50))及其95%可信区间(95%CI)。结果 R组与RF组罗哌卡因EC_(50)(95%CI)分别为0.251%(0.231%~0.274%)和0.219%(0.198%~0.245%)。与R组比较,RF组罗哌卡因EC_(50)降低,降低幅度为13%。结论 B超引导下复合小剂量芬太尼可显著强化罗哌卡因锁骨上臂丛神经阻滞的效果。
[Abstract]:Objective to study the effect of fentanyl on the minimum effective concentration of ropivacaine in brachial plexus block. Methods 100 patients were randomly divided into ropivacaine group (R group) and ropivacaine combined with fentanyl group (RF group). Both groups were treated with supraclavicular brachial plexus block under ultrasound guidance. Ropivacaine and 0.05mg fentanyl were injected into ropivacaine group and RF group. The initial concentration of ropivacaine was 0.30%, the sequential method was used, the ratio of adjacent concentration was 1.2. Visual analogue score (VAS) was used to evaluate the efficacy of anesthesia in 30min after injection and to record the perianaesthesia related complications. The half-effective concentration (EC50) of ropivacaine and its 95% confidence interval (95CI) were calculated by Dixon-Ma s s e y method. Results the EC50 (95 CI) of ropivacaine in group R and RF were 0.251% (0.231 and 0.274%) and 0.219% (0.198 0.245%), respectively. Compared with R group, ropivacaine EC50 in RF group was decreased by 13%. Conclusion combined with low dose fentanyl under B-ultrasound guidance can significantly enhance the effect of ropivacaine superior clavicular brachial plexus block.
【作者单位】： 浙江大学医学院附属第一医院麻醉科;浙江省人民医院;浙江省人民医院麻醉科;
【分类号】：R614
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本文编号：2098808