超声引导下锁骨上臂丛神经阻滞0.375%盐酸罗哌卡因的半数有效剂量

目的测定超声引导下锁骨上臂丛神经阻滞0.375%盐酸罗哌卡因的半数有效剂量。方法选择择期行手或前臂手术的40例患者(ASA分级Ⅰ-Ⅱ级),采用超声引导下锁骨上臂丛神经阻滞两点注射法注入0.375%盐酸罗哌卡因,盐酸罗哌卡因的剂量分别由低到高设为12、14、16、18和20 mL,初始剂量16 mL,间隔剂量为2 mL,注药30 min后切皮时,视觉模拟评分(VAS)>3分,改为全身麻醉以及下一例采用高一级剂量。若VAS≤3分,则下一例采用低一级剂量。采用Probit法计算超声引导下锁骨上臂丛神经阻滞0.375%盐酸罗哌卡因的半数有效剂量及其95%可信区间(CI)。结果超声引导下锁骨上臂丛神经阻滞0.375%盐酸罗哌卡因的半数有效剂量为15.9 mL,95%CI为12.7~19.1 mL。结论正常成人超声引导下锁骨上臂丛神经阻滞0.375%盐酸罗哌卡因的半数有效剂量为15.9 mL。

Median Effective Dosage of 0.375%Ropivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

Objective To determine the median effective dosage of 0.375% ropivacaine in ultrasound-guided supraclavicular brachial plexus block.Methods Forty ASAⅠ-Ⅱpatients scheduled for hand or forearm surgery were given two-point injection with 0.375% ropivacaine at doses of 12, 14, 16,18 and 20 mL for ultrasound-guided supraclavicular brachial plexus block. The initial concentration was set at 16 mL. Dosage interval was 2 mL.The anesthetic efficacy was assessed with visual analogue scale （VAS） 30 minutes after injection. If VAS score was greater than 3,general anesthesia was performed and the next case was given a higher dose of ropivacaine. If VAS score was less than or equal to 3,the next case was given a lower dose of ropivacaine. The median effective dosage of 0.375%ropivacaine in ultrasound-guided supraclavicular brachial plexus block and 95% confidence interval were calculated using Probit analysis. Results The median effective dosage of 0.375% ropivacaine in ultrasound-guided supraclavicular brachial plexus block was 15.9 mL,and the 95% confidence interval ranged from 12.7 to 19.1 mL. Conclusion The median effective dosage of 0.375% ropivacaine in ultrasound-guided supraclavicular brachial plexus block was 15.9 mL in normal adults.