天津医药

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老年患者后路腰丛阻滞罗哌卡因半数有效剂量的临床研究

马琳1,于泳浩1,杨勇2   

  1. 1. 天津医科大学总医院麻醉科
    2. 总医院麻醉科
  • 收稿日期:2009-10-29 修回日期:2010-03-08 出版日期:2010-07-15 发布日期:2010-07-15
  • 通讯作者: 马琳

The clinical study of median effective dose of ropivacaine for lumbar plexus blockade in elderly patients

  • Received:2009-10-29 Revised:2010-03-08 Published:2010-07-15 Online:2010-07-15
  • Contact: Ma Lin

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摘要： 摘要 目的 探讨老年患者后路腰丛阻滞时罗哌卡因的半数有效剂量（ED50）。方法 单侧下肢手术患者，年龄65～85岁为老年组，年龄18～35岁为青年组，每组20例。所有患者采用后路腰丛阻滞联合坐骨神经阻滞。腰丛给药方法按序贯法确定，各相邻剂量之间的比率为1.12，以完善的感觉和运动神经阻滞为腰丛阻滞成功标准。结果 老年组0.375%罗哌卡因ED50及其95%CI 为28.84 (27.42～30.45) ml，青年组为34.28（32.24～35.61）ml，老年组罗哌卡因ED50明显低于青年组（P<0.05）。结论 老年患者后路腰丛阻滞时罗哌卡因ED50明显减少。

关键词: 罗哌卡因, 腰丛, 麻醉, 半数有效剂量

Abstract: The clinical study of median effective dose of ropivacaine for lumbar plexus blockade in elderly patients MA Lin,YangYong, YU Yong-hao Department of Anesthesiology, General Hospital, Tianjin Medical University, Tianjin 300052, China Abstract Objective： To determine the median effective dose（ED50） of ropivacaine for lumbar plexus blockade in elderly patients. Methods：Forty patients ,aged 65～85(n=20) or 18～35(n=20) underwent lumbar plexus and sciatic nerve blockade for operations of unilateral lower extremities. The volume of local anesthetic used in each patient was based on the up-and-down method for lumbar plexus blockade. The ratio of two consecutive dose was 1.12. Successful nerve block was defined as complete loss of pinprick sensation in the femoral nerve distribution , with concomitant inability to extend the affected leg within 30 min after local anesthetic injection. Results：The ED50 of 0.375% ropivacaine was 28.84 ml in the older group and 34.28 ml in the younger group （P<0.05）.The 95% confidence interval was 27.42～30.45 ml in the older group and 32.24～35.61 ml in the younger group. Conclusion：The ED50 of ropivacaine for lumbar plexus blockade is significant decrease in elderly patients.

Key words: Ropivacaine, Lumbar plexus, Anesthesia, Median effective dose