利多卡因用于经尿道膀胱肿瘤电切术患者神经刺激仪引导闭孔神经阻滞时的半数有效浓度

Median effective concentration of lidocaine for obturator nerve block guided by nerve stimulator in patients undergoing transurethral resection of bladder tumor

目的 确定利多卡因用于经尿道膀胱肿瘤电切术患者神经刺激仪引导闭孔神经阻滞时的半数有效浓度（EC50）.方法 选择拟行经尿道膀胱肿瘤电切术的膀胱侧壁肿瘤患者,术前根据膀胱镜检或CT检查确定需行闭孔神经阻滞,ASA分级Ⅰ或Ⅱ级,体重指数19～30 kg/m2,年龄18～64岁,在神经刺激仪引导下经腹股沟上入路用利多卡因进行闭孔神经阻滞,利多卡因浓度根据序贯法确定,初始浓度为1.5％,相邻浓度之比为1.2.闭孔神经阻滞成功为阳性反应.计算利多卡因用于经尿道膀胱肿瘤电切术患者神经刺激仪引导闭孔神经阻滞时的EC50及其95％可信区间.结果 利多卡因用于经尿道膀胱肿瘤电切术患者神经刺激仪引导闭孔神经阻滞时的EC50为0.57％,95％可信区间为0.55％ ～ 0.59％.结论 利多卡因用于经尿道膀胱肿瘤电切术患者神经刺激仪引导闭孔神经阻滞时的EC50为0.57％.

Objective To determine the median effective concentration （EC50） of lidocaine for obturator nerve block （ONB） guided by a nerve stimulator in patients undergoing transurethral resection of bladder tumor （TURBT）.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients with bladder tumor,scheduled for elective TURBT,required ONB according to the results of cystoscopy or CT examination performed before operation,with body mass index of 19-30 kg/m2,aged 18-64 yr,were enrolled in the study.ONB was performed with lidocaine using the suprainguinal approach under the guidance of a nerve stimulator.The concentration of lidocaine was determined by up-and-down sequential trial.The initial concentration of lidocaine was 1.5%,and the ratio between the two successive concentrations was 1.2.Successful ONB was considered to be positive response.The EC50 and 95% confidence interval of lidocaine for ONB guided by a nerve stimulator was calculated.Results The EC50 of lidocaine was 0.57%,and the 95% confidence interval was 0.55%-0.59% when used for ONB guided by a nerve stimulator.Conclusion The EC50 of lidocaine is 0.57% when used for ONB guided by a nerve stimulator in the patients undergoing TURBT.