摘要
目的研究左旋布比卡因蛛网膜下腔阻滞用于剖宫产的量效关系。方法择期剖宫产患者120例,随机、双盲分为4组。于L2~3间隙行蛛网膜下腔阻滞麻醉,分别注射左旋布比卡因5 mg（A组）,7.5 mg（B组）,11.5 mg（C组）,15 mg（D组）。采用针刺法测定感觉阻滞平面,改良Bromage评分法测定下肢运动神经阻滞程度,VAS评分法评估病人的疼痛程度,术者评估腹壁松弛度,记录麻醉的不良反应。采用Probit法计算50%和95%患者镇痛有效的左旋布比卡因剂量（ED50和ED95）以及95%可信区间。结果随着剂量的加大,运动阻滞起效时间逐渐缩短,Bromage评分逐渐提高,感觉和运动恢复时间逐渐延长。4组镇痛的有效率分别为37%、69%、95%、100%,腹壁松弛度＂很松＂的分别为28%、51%、93%、100%。麻醉后不良反应少。左旋布比卡因的ED50为9.95 mg（95%CI 9.31~10.62 mg）和ED95为13.76 mg（95%CI 13.67~14.54 mg）。结论 左旋布比卡因蛛网膜下腔阻滞用于剖宫产的ED50为9.95 mg,ED95为13.76 mg。
Objective To evaluate the dose-effect relationship of L-bupivacaine through subarachnoid block in caesarean delivery.Method One hundred women of elective caesarean section were allocated into 4 groups at random and double blindly.All adapted L-bupivacaine through subarachnoid block in L23 with different dosages.Group A： 5 mg,B：7.5 mg,C： 11.5 mg,D： 15 mg.Block plane was evaluated with needle.Upgraded Bromage forked method was used to assess the degree of lower limb motor block,and VAS forked method for the assessment of the ache degree.The abdomen wall relaxation degree was evaluated by the operator.Side effects of anesthesia were recorded.Probit method was used to calculate the effective analgesia dosage（ED（50）,ED（95）） and 95% confidence interval.Results as the dosage goes up,the motor nerve block comes quicker,Bromage scores increasingly higher,and the recovery time longer.The effective analgesia rates of the four groups are 37%,69%,95%,100% respectively.Abdomen wall relaxation degree as satisfactory is 28%,51%,93%,100% each.Conclusion In our country,ED（50） and ED（95） of L-bupivacaine with subarachnoid block in caesarean delivery are 9.95 mg,13.76 mg respectively.
出处
《实用临床医药杂志》
CAS
2011年第3期115-117,共3页
Journal of Clinical Medicine in Practice
关键词
左旋布比卡因
量效关系
蛛网膜下腔阻滞
剖宫产
L-bupivacaine
the dose-effect relationship
subarachnoid block
caesarean delivery
