下肢手术患者蛛网膜下腔注射不同等比重局麻药的药效学分析

Pharmacodymmics ofdifferentlocal anesthefla administered intrathecally for Patients with lower limb surgery

目的分析下肢手术患者蛛网膜下腔注射不同比重罗哌卡因的药效学。方法将84例择期行下肢手术的患者按随机数字表平均分为3组,A、B、C 3组分别于蛛网膜下腔注射0.5%比重的罗哌卡因、左旋布比卡及布比卡因,采用序贯法确定3种局麻药的50%有效剂量(ED50)及95%有效剂量(ED95)。结果 A、B、C 3组ED50分别为(10.5±4.3)mg、(8.1±3.4)mg、(6.2±2.8)mg;ED95分别为(12.1±4.3)mg、(9.6±3.8)mg、(7.7±2.6)mg;有效价比分别为0.58:0.76:1.00。结论等比重的罗哌卡因、左旋布比卡及布比卡因用于下肢手术患者麻醉,3种局麻药的效价比为0.58:0.76:1.00,临床应根据药效学分析结果选择局麻药。

Objective analysis of lower extremity surgery in patients with subarachnoid injection of different proportion of ropivacaine pharmacodynamics. Methods 84 patients undergoing elective lower limb surgery patients were randomly divided equally into three groups, three groups A, B, and C, respectively, in the subarachnoid injection of 0.5% isobaric ropivacaine and L-bupivacaine and cloth Cain, the sequential method to determine the three local anesthetics median effective dose （ED50） and 95% effective dose （ED95）. Results A, B, C three groups of ED50, respectively （10.5 ± 4.3） mg （8.1 ± 3.4） mg（6.2 ± 2.8）mg; ED95, respectively （12.1 ± 4.3） mg （9.6 ± 3.8） mg, （7.7 ± 2.6） mg; effective bid were 0.58：0.76：1.00. Conclusion isobaric ropivacaine and L-bupivacaine and bupivacaine for patients with lower limb surgery anesthetic, bupivacaine valid bid was the highest, followed by the L-bupivacaine, in the lower extremity anesthesia should be preferred bupivacaine.