当前位置: 首页 » 论文全文
←返回首页
期刊信息:
《药学服务与研究》2019年, 第19卷, 第3期, 第188-191页
标题:
右美托咪定行超声引导下臂丛神经阻滞时罗哌卡因的半数有效剂量研究
DOI:
10.5428/pcar20190308
作者:
1. 周艳(海军军医大学长海医院麻醉学部 上海 200433 13564155655@163.com)
2. 凡丽华(海军军医大学长海医院麻醉学部 上海 200433 )
3. 张丽君(海军军医大学长海医院麻醉学部 上海 200433 )
4. 邓瑜(海军军医大学长海医院麻醉学部 上海 200433 )
5. 卜岚(海军军医大学长海医院麻醉学部 上海 200433 )
6. 刘征(海军军医大学长海医院麻醉学部 上海 200433 liuzheng19821007@icloud.com)
摘要:
摘要  目的:探索行超声引导下臂丛神经阻滞联合应用右美托咪定时0.375%罗哌卡因的半数有效剂量(ED50)。方法:选取择期行肩关节镜手术的患者30例,性别不限,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ级或Ⅱ级。患者入手术室即开始泵注右美托咪定(0.5 μg·kg-1·h-1),于超声引导下行肌间沟臂丛阻滞,给予0.375%罗哌卡因首剂量100 mg,后各相邻患者剂量之间的比值为1.2。采用改良序贯法计算0.375%罗哌卡因的ED50及95%可信区间。观察患者的麻醉效果及有无药品不良反应(ADRs)发生。结果:肩关节镜手术患者行超声引导下臂丛神经阻滞复合右美托咪定时0.375%罗哌卡因的ED50为19 ml,95%可信区间为17.5~21.5 ml。ADRs观察发现1例霍纳(Horner)综合征,1例低心率、低血压事件。结论:肩关节镜手术患者行超声引导下臂丛神经阻滞时复合右美托咪定,可减少罗哌卡因的剂量,且麻醉效果好,无严重ADRs发生。
欢迎阅读《药学服务与研究》!您是该文第 159 位读者!
若需在您的论文中引用此文,请按以下格式著录参考文献:
中文著录格式 周艳,凡丽华,张丽君,邓瑜,卜岚,刘征. 右美托咪定行超声引导下臂丛神经阻滞时罗哌卡因的半数有效剂量研究[J]. 药学服务与研究. 2019; 19(3): 188-191.
英文著录格式 ZHOU Yan,FAN Lihua,ZHANG Lijun,DENG Yu,BU Lan,LIU Zheng. Study on median effective dose of ropivacaine combined with dexmedetomidine for ultrasound-guided interscalene brachial plexus block for arthroscopic shoulder surgery[J]. Pharmaceutical Care and Research / yao xue fu wu yu yan jiu. 2019; 19(3): 188-191.
参考文献:
1. Hughes M S,Matava M J,Wright R W,et al.Interscalene brachial plexus block for arthroscopic shoulder surgery: a systematic review[J].J Bone Joint Surg Am,2013,95(14):1318-1324.
2. McNaught A,Shastri U,Carmichael N,et al.Ultrasound reduces the minimun effective local anaesthetic volume compared with peripheral nerve stimulation for interscalene block[J].Br J Anaesth,2011,106(1):124-130.
3. Kang R,Jeong J S,Yoo J C,et al.Effective dose of intravenous dexmedetomidine to prolong the analgesic duration of interscalene brachial plexus block:a single-center,prospective,double-blind,randomized controlled trial[J].Reg Anesth Pain Med,2018,43(5):488-495.
4. 吴新民,薛张纲,马虹,等.右美托咪定临床应用专家共识(2018)[J].临床麻醉学杂志,2018,34(8):820-823.
5. Saranteas T,Finlayson R J,Tran D Q.Dose-finding methodology for peripheral nerve blocks[J].Reg Anesth Pain Med,2014,39(6):550-555.
6. Stylianou M,Proschan M,Flournoy N.Estimating the probability of toxicity at the target dose following an up-and-down design[J].Stat Med,2003,22(4):535-543.
7. Pace N L,Stylianou M P.Advances in and limitations of up-and-down methodology:a précis of clinical use,study design,and dose estimation in anesthesia research[J].Anesthesiology,2007,107(1):144-152.
8. Vorobeichik L,Brull R,Abdallah F W.Evidence basis for using perineural dexmedetomidine to enhance the quality of brachial plexus nerve blocks:a systematic review and meta-analysis of randomized controlled trials[J].Br J Anaesth,2017,118(2):167-181.
9. Gautier P,Vandepitte C,Ramquet C,et al.The minimum effective anesthetic volume of 0.75% ropivacaine in ultrasound-guided interscalene brachial plexus block[J].Anesth Analg,2011,113(4):951-955.
10. Shin S W,Byeon G J,Yoon J U,et al.Effective analgesia with ultrasound-guided interscalene brachial plexus block for postoperative pain control after arthroscopic rotator cuff repair[J].J Anesth,2014,28(1):64-69.
11. 李挺,曹亲亲,李军.不同浓度罗哌卡因用于臂丛神经感觉与运动分离阻滞的效果[J].中华麻醉学杂志,2010,30(12):1462-1464.
12. 肖实,曲良超,曾剑文,等.罗哌卡因臂丛运动与感觉分离阻滞在显微手术中的应用[J].中华显微外科杂志,2011,34(4):311-312.
13. Chierichini A,Frassanito L,Vergari A,et al.The effect of norepinephrine versus epinephrine in irrigation fluid on the incidence of hypotensive/bradycardic events during arthroscopic rotator cuff repair with interscalene block in the sitting position[J].Arthroscopy,2015,31(5):800-806.
14. Orebaugh S L,Williams B A,Bigeleisen P E.The up-down methodology and practical peripheral nerve blockade[J].Reg Anesth Pain Med,2010,35(5):480-481.