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| 舒芬太尼局部用药对罗哌卡因胸椎旁神经阻滞半数有效浓度的影响 |
| Effect of sufentanil administered locally on mediam effective concentration of ropivacaine for thoracic paravertebral block |
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| DOI：10.12089/jca.2020.06.005 |
| 中文关键词: 胸椎旁阻滞 舒芬太尼 罗哌卡因 序贯法 |
| 英文关键词: Thoracic paravertebral block Sufentanil Ropivacaine Sequential method |
| 基金项目:兰州大学第二医院萃英学子科研培育计划（CYXZ 41） |
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| 中文摘要: |
目的 探讨舒芬太尼局部用药对超声引导下胸椎旁阻滞罗哌卡因半数有效浓度(EC50)的影响。
方法 择期行胸腔镜下肺叶切除术的患者42例，男23例，女19例，年龄30～65岁，BMI 18～28 kg／m2，ASA Ⅰ—Ⅲ级，在T4-5水平行超声引导下椎旁神经阻滞。采用随机数字表法将患者分为两组：对照组（C组）和观察组（T组）。C组神经阻滞用药为罗哌卡因20 ml；T组神经阻滞用药为罗哌卡因复合舒芬太尼0.6 ug/ml的混合液20 ml。罗哌卡因浓度由上下序贯法确定，起始浓度为0.5%，间隔浓度比值为1.2。若阻滞效果评定为优良，则下一例采用低一级浓度；若阻滞效果评定为差，则下一例采用高一级浓度。研究终点为达到7个上下周期，或者罗哌卡因浓度≤0.1%或≥1%并持续7例。按照Dixion-Massey EC50序贯法计算公式计算罗哌卡因EC50及其95%CI。
结果 C组罗哌卡因EC50为0.41%，95%CI为0.39%～0.43%；T组罗哌卡因EC50为0.33%，95%CI为0.31%～0.35%。
结论 复合舒芬太尼0.6 μg/ml局部用药可降低罗哌卡因胸椎旁阻滞的EC50。 |
| 英文摘要: |
Ojective To investigate effect of sufentanil on the mediam effective concentration (EC50) of ropivacaine for thoracic paravertebral block.
Methods Forty-two patients with lung disease scheduled for lobectomy under video-assisted thoracoscopic surgery, 23 males and 19 females, aged 30-65 years, with a BMI of 18-28 kg／m2, falling into ASA physical status Ⅰ-Ⅲ, were randomly divided: control group (group C) and observation group (group T).All patients received ultrasound-guided thoracic paravertebral block at the level of T4-T5. Paravenebral block was performed by using only ropivacaine in group C. The mixture of ropivacaine and 0.6 μg/ml sufentanil was injected for the block in group T. The concentration of ropivacaine was determined by the up-and-down sequential method. The initial concentration of ropivacaine was 0.5％ and the ratio between the two successive concentrations was 1.2. If the block was effective, the next patient received a lower dose of ropivacaine, or if ineffective, a higher dose was given to the next patient. End point of the study was 7 up-and-down cycles, or ropivacaine concentration ≤ 0.1%, or ≥ 1% and continued for 7 cases. The EC50 and 95% confidence interval (CI) of ropivacaine were determined by using the formula of Dixion-Massey sequential method.
Results The EC50 of ropivacaine was 0.41%, and the 95% CI was 0.39%-0.43% in group C. The EC50 of ropivacaine was 0.33%, and the 95% CI was 0.31%-0.35% in group T.
Conclusion The combined use of sufentanil can decrease the EC50 of ropivacaine for ultrasound-guided thoracic paravertebral block. |
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