本文選題：芬太尼 + 羅哌卡因　； 參考：《浙江醫(yī)學(xué)》2016年24期

【摘要】：目的研究芬太尼局部用藥對(duì)羅哌卡因臂叢神經(jīng)阻滯最低有效濃度的影響。方法將100例擇期手術(shù)患者按隨機(jī)數(shù)字表法分為羅哌卡因組(R組)和羅哌卡因復(fù)合芬太尼組(RF組),各50例。兩組患者均在超聲引導(dǎo)下行鎖骨上臂叢神經(jīng)阻滯,R組注射30ml的羅哌卡因,RF組注射羅哌卡因與0.05mg芬太尼混合液,羅哌卡因以0.30%為起始濃度,采用序貫法,相鄰濃度比值為1.2。注藥后30min內(nèi)通過視覺模擬法評(píng)分(VAS)評(píng)定麻醉是否有效,同時(shí)記錄圍麻醉期相關(guān)并發(fā)癥。采用Dixon-Ma s s e y法計(jì)算羅哌卡因的半數(shù)有效濃度(EC_(50))及其95%可信區(qū)間(95%CI)。結(jié)果 R組與RF組羅哌卡因EC_(50)(95%CI)分別為0.251%(0.231%~0.274%)和0.219%(0.198%~0.245%)。與R組比較,RF組羅哌卡因EC_(50)降低,降低幅度為13%。結(jié)論 B超引導(dǎo)下復(fù)合小劑量芬太尼可顯著強(qiáng)化羅哌卡因鎖骨上臂叢神經(jīng)阻滯的效果。
[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.
【作者單位】： 浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院麻醉科;浙江省人民醫(yī)院;浙江省人民醫(yī)院麻醉科;
【分類號(hào)】：R614
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本文編號(hào)：2098808