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老年患者左旋布比卡因硬膜外运动阻滞的半数有效浓度 被引量:3

The median effective concentration of levobupivacaine for motor blockade during epidural anesthesia in the elderly
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摘要 目的研究老年和青壮年患者左旋布比卡因硬膜外运动阻滞的半数有效浓度(EC50)。方法60例下肢或下腹部择期手术患者分成老年组(A组,≥70岁)和青壮年组(Y组,<70岁),每组30例。硬膜外穿刺置管后注入15ml不同浓度的左旋布比卡因:每组第一位患者左旋布比卡因浓度均定为0.375%,其后各患者所用浓度按序贯法进行选择,浓度变化梯度定为0.025%。以改良Bromage评分法判断运动阻滞程度,计算硬膜外左旋布比卡因运动阻滞的EC50。结果A组左旋布比卡因硬膜外运动阻滞的EC50为0.349%(95%可信区间:0.327%~0.373%),显著低于Y组的0.453%(95%可信区间:0.424%~0.484%)(P<0.01)。结论与青壮年患者相比,老年患者左旋布比卡因硬膜外运动阻滞的EC50明显降低。 Objective To investigate the median effective concentration (EC50) of levobupivacaine for motor blockade during epidural anesthesia in the elderly. Methods Sixty patients undergoing lower abdominal or lower extremity surgery were divided into elder group(≥70 years old, group A) and younger group(〈70 years old,group Y) with 30 cases each. The patients of two groups received a bolus of 15 ml levobupivacaine through the epidural catheter. The concentration for the first patient of each group was 0.375% and the concentration of levobupivacaine for the next was determined according to up-down sequential allocation with the testing interval of 0. 025 %. The plane of motor blockade was scored with modified Bromage motor scale and then the EC50 for motor blockade was calculated. Results The EC50 of levobupivacaine for motor blockade was 0. 349 % (95 % confidence interval was 0. 327 % to 0. 373%) in group A, which was significantly lower than 0. 453 % (95% confidence interval was 0. 424% to 0. 484%) in group Y(P〈0. 01). Conclusion The EC50 of levobupivacaine for motor blockade after epidural administration is lower in the elderly than that in the younger.
出处 《临床麻醉学杂志》 CAS CSCD 北大核心 2009年第6期471-473,共3页 Journal of Clinical Anesthesiology
关键词 左旋布比卡因 硬膜外阻滞 半数有效浓度 老年 Levobupivacaine Epidural blockade Median effective concentration Geriatrics
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参考文献9

  • 1陆守曾.半数效量.见:郭祖超,主编.医用数理统计方法.第3版.北京:人民卫生出版社,1998.666-690.
  • 2李荣胜,马武华,王心田,黎峰,庄新茂,高晓秋.妇科硬膜外左旋与消旋布比卡因运动阻滞效能比较[J].国际麻醉学与复苏杂志,2006,27(4):200-202. 被引量:9
  • 3Chang DH, Ladd LA, Wilson KA,et al. Tolerability of largedose intravenous levobupivaeaine in sheep. Anesth Analg, 2000,91 : 671-679.
  • 4Lacassie HJ, Columb MO, Lacassie HP, et al. The relative motor blocking potencies of epidural bupivacaine and ropivacaine in labor. Anesth Analg, 2002,95:204-208.
  • 5Lyons G, Columb M, Wilson RC, et al. Epidural pain relief in labour: potencies of levobupivacaine and racemic bupivacaine. Br J Anaesth, 1998,81 : 899-901.
  • 6Nydahl PA, Philipson L, Axelsson K, et al. Epidual anesthesia with 0. 5M bupivcaine: influence of age on sensory and motor blockade. Anesth Analg, 1991,73 : 780-786.
  • 7Mischa JG,Simon MD,Bemadette T,et al. The effects of age on neural blockade and hemodynamic changes after epidural anesthesia with ropivacaine. Anesth Analg, 2002, 94: 1325- 1330.
  • 8Li Y,Zhu S,Bao F,et al. The effects of age on the median effective concentration of ropivaeaine for motor blockade after epidural anesthesia with ropivacaine. Anesth Analg, 2006, 102: 1847-1850.
  • 9Benhamou D, Ghosh C, Mercier FJ, et al. A Randomized Sequential allocation study to determine the minimum effective analgesic concentration of tevobupivacaine and ropivacaine in patients receiving epidural analgesia for labor. Anesth Analg, 2004,24:80-81.

二级参考文献6

  • 1Capogna G,Celleno D,Fusco P,et al.Relative potencies of bupivacaine and ropivacaine for analgesia in labour.Br J Anaesth,1999,82(3):371-373.
  • 2Lacassie HJ,Columb MO,Lacassie HP,et al.The relative motor blocking potencies of epidural bupivacaine and ropivacaine in labor.Anesth Analg,2002,95(1):204-208.
  • 3Lyons G,Columb M,Wilson RC,et al.Epidural pain relief in labour:potencies of levobupivacaine and racemic bupivacaine.Br J Anaesth,1998,81(6):899-901.
  • 4Chang DH,Ladd LA,Wilson KA,et al.Tolerability of large-dose intravenous levobupivacaine in sheep.Anesth Analg,2000,91(3):671-679.
  • 5黎尚荣,马武华,甘小亮,罗刚健,陈秉学.序贯试验测定自然分娩时硬膜外罗哌卡因镇痛的EC_(50)[J].中华麻醉学杂志,2003,23(2):95-97. 被引量:28
  • 6孙雪峰,刘甦,郝建华,李平,张英民.硬膜外罗哌卡因用于下肢手术术后镇痛的最低运动阻滞浓度[J].中华麻醉学杂志,2004,24(4):311-312. 被引量:26

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  • 1Malinovsky JM, Renaud G, Le Corre P, et al. intrathecal bupivacaine in humans :influence of volume and baricity of solutions [J]. Anesthesiology, 1999,91 (5) : 1260 - 1266.
  • 2Axelsson K, Hallgren S, Widman B, et al. A new method for measuring motor block in the lower extremities [J]. Acta Anaesthesiol Scand, 1985,29 ( 1 ) :72 - 78.
  • 3Wood MB,Rubin AP. Acomparison of epidural 1% ropivacaine and 0. 75% bupivacaine for lower abdominal gynecologic surgery [J]. Anesth Analg, 1999,76(6) :1274 - 1278.
  • 4Valanne JV,Korhonen AM,Jokela RM,et al. Selective spinal anesthesia:a comparison d hyperberic bupivacaine 4 mg Versus 6 mg for outpatient knee arthroscopy[J].Anesth Analg,2001,93(6) :1377 -1379.
  • 5Varrassi G, Celleno D, Capogna G, et al. Ventilatory effects of subarachnoid fentanyl in the elderly[J].Anaesthesia, 1992,47 (7): 558 - 562.
  • 6Axelsson K,Nydahl P-A,Philipson L,et al. Motor and sensory blockade after epidural injection of mepivacaine,bupivacaine,and etidocaine-a double-blind study[J].Anesth Analg, 1989,69(0) :739 - 747.
  • 7Li Y, Zhu S, Bao F, et al. The effects of age on the median effective concentration ropivacaine for motor blockade afer epidural anesthesia with ropivacaine[J].Anesth Analg,2006,102(6) :1847 - 1850.
  • 8Benhamou D, Ghosh C, Mercier FJ. A randomized sequential allocation study to determine the minimum effective analgesic concentration of ievobupivacaine and ropivacaine in patients receiving epidural analgesia for labor[J].Anesthesiology,2003,99 (6) : 1383 - 1386.
  • 9van Zundert A, Vaes L, Van der Aa P, et al. Motor blockade during epidural anesthesia[J].Anesth Analg, 1986,65 (4) :333 - 336.
  • 10Ohmura S,Kawada M,Ohta T,et al.Systemic toxicity and resuscitation in bupivacaine-,levobupivacaine-,or ropivacaine-infused rats[J].Anesth Analg,2001,93(3):743-748.

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