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| 0.3%罗哌卡因用于老年患者超声引导下髂筋膜间隙阻滞的半数有效容量 |
| Median effective volume of 0.3% ropivacaine in old patients with femoral intertrochanteric fracture undergoing ultrasound-guided fascia iliaca compartment block |
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| DOI：10.12089/jca.2017.12.1152 |
| 中文关键词: 髂筋膜间隙阻滞 超声检查 股骨粗隆间骨折 罗哌卡因 半数有效容量 |
| 英文关键词: Fascia iliaca compartment block Ultrasonography Femoral intertrochanteric fracture Ropivacaine Median effect volume |
| 基金项目:福建省卫生计生委青年科研课题(2017-1-89) |
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| 中文摘要: |
目的 采用序贯法测定0.3%罗哌卡因用于老年患者股骨粗隆间骨折行超声引导下髂筋膜间隙阻滞(fascia iliaca compartment block, FICB)的半数有效容量(median effective volume, EV50)。
方法 选择2016年1～12月本院行股骨粗隆间骨折手术患者39例, 男18例, 女21例, 年龄65～98岁, ASA Ⅱ或Ⅲ级, 在超声引导下行FICB。从预试验中出现阳性反应的其中一个较大剂量开始进行试验, 第一例患者阻滞后30 min内疼痛完全缓解视为阻滞成功, 下一例患者则给予低一级剂量; 相反, 如果阻滞后30 min内疼痛部分缓解或无缓解则为阻滞失败, 下一例患者则给予高一级剂量, 以此类推, 直至出现7个拐点时试验完成, 相邻容量比为1.13。采用概率回归法计算罗哌卡因EV50及其95%可信区间(CI)。
结果 39例患者中20例(51.3%)阻滞成功。0.3%罗哌卡因EV50为25.37 ml(95%CI 22.06～29.19 ml)。
结论 超声引导下FICB用于老年患者股骨粗隆间骨折手术时0.3%罗哌卡因的半数有效容量为25.37 ml。 |
| 英文摘要: |
Objective To identify the median effective volume (EV50) of 0.3% ropivacaine in the old patients with femoral intertrochanteric fracture undergoing ultrasound-guided fascia iliaca compartment block (FICB).
Methods Thirty-nine patients, 18 males and 21 females, aged 65-98 years old, ASA physical status Ⅱ or Ⅲ, scheduled for femoral intertrochanteric fracture surgery were sequentially received ultrasound-guided FICB. Patients were sequentially given a pre-set volume of 0.3% ropivacaine according to our pilot study. A sign of “+” was marked if the patient was positive to FICB and totally pain-free 30 min after block, and the next patient would be assigned to a lower volume of ropivacaine. Otherwise, a sign of “-” was marked if the patient was negative to FICB that was partially or not pain reliefed 30 min after block, and the next patient would be assigned to a larger volume of ropivacaine. The trial was terminated when 7 inflection points appeared. The EV50 of 0.3% ropivacaine with 95% confidence interval (CI) was calculated according to sequential method.
Results Twenty (51.3%) in a total of 39 patients received a successful ultrasound-guided FICB. The EV50 and 95% CI of 0.3% ropivacaine using ultrasound-guided FICB in old patients with femoral intertrochanteric fracture was 25.37 ml (95%CI 22.06-29.19 ml).
Conclusion The EV50 of 0.3% ropivacaine using ultrasound-guided FICB in the old patients with femoral intertrochanteric fracture is 25.37 ml. |
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