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时间:2017-12-07
《三种不同局麻药腰麻最大运动阻滞效应的比较》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、·67O·临床麻醉学杂志2010年8月第26卷第8期JClinAnesthesiol,August2010,Vo1.26,No.8.临床研究.三种不同局麻药腰麻最大运动阻滞效应的比较黄绍强王婷婷李宁耿桂启胡建英【摘要】目的采用序贯试验评估罗哌卡因、左旋布比卡因和布比卡因鞘内注射后达到Bromage3级的半数有效剂量(ED5。),比较三种局麻药腰麻的运动阻滞效应。方法腰一硬联合麻醉(CSEA)下择期行妇科手术患者99例,随机分为罗哌卡因组、左旋布比卡因组和布比卡因组,分别鞘内注射0.5等比重罗哌卡因、左旋布比卡因或布比卡因,起始剂量均为7mg,剂量变化梯度为1mg,鞘内注药后25min内双下
2、肢改良Bromage达到3级为有效。结果罗哌卡因组腰麻产生最大运动阻滞的ED50为9.62mg,95可信区问(cI)为9.16~10.09mg;左旋布比卡因组的E。为9.55mg,95CI为9.O1~10.1lmg;布比卡因组的EI)s。为6.08mg,95CI为5.39~6.80mg。罗哌卡因最大运动阻滞相对效价比是布比卡因的0.63倍(95C10.56~0.73)。结论罗哌卡因和左旋布比卡因腰麻的运动阻滞效应明显低于布比卡因,而罗哌卡因与左旋布比卡因无明显差异。【关键词】脊髓麻醉;罗哌卡因;左旋布比卡因;布比卡因;运动阻滞Estimationofthemaximummotorblock
3、ingpotencyratioforintrathecalropivacaine,levobupivacaineandbupivacaineHUANGShao-qiang,WANGTing-ting,LlNing,ela1.DepartmentofAnesthesiology,ObstetricsandGynecologyHospital,FudanUniversity,Shanghai200011,China[Abstract]ObjectiveTodeterminethemedianeffectivedose(E0)formaximummotorblockofintrathecalbu
4、pivacaine,levobupivacaineandropivaeaine,andtodefinetheirm0tor—blockingpotencyratio.MethodsInthisprospective,randomised,doubleblind,parallelgroup,up-downsequentia}allocationstudy,weenrolled99patientsundergoingselectivegynecologicalsurgerywithcombinedspinal—epidura1anesthesia(CSEA)andrandomizedthemt
5、ooneofthreegroupstOreceiveintrathecal0.5(wt/vo1)bupivacaine,levohupivacaineandropivacaine,respectively.Theinitialdosewas7mgandthetestingintervalwassetat1mg.EfficacywasdeterminedbytheoccurrenceofmodifiedBromage3inbothlower1imbswithin25minafterspinalinjection.ResultsIntrathecalED5nformaximummotorblo
6、ckwas9.62mgforropivacaine(95C19.16—1O.O9),9.55mgforlevobupivacaine(950oCI9.O1一lO.11),6.08mgforbupivacaine(95CI5.39—6.8O)(P7、sionIntratheca1bupivacaineiSmorepotentthanlevobuDivacaineandropivacaineformotorblock,whichiSnotsignificantlydifferentbetweenlevobuDivacaineandropivacaine.[Keywords]Spinalanesthesia;Ropivacaine;Levobupivacaine;Bup
7、sionIntratheca1bupivacaineiSmorepotentthanlevobuDivacaineandropivacaineformotorblock,whichiSnotsignificantlydifferentbetweenlevobuDivacaineandropivacaine.[Keywords]Spinalanesthesia;Ropivacaine;Levobupivacaine;Bup
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