Chen Ming-Quan, Chen Chun, Ke Qi-Bin
Department of Anesthesiology, The First College of Clinical Medical Science, China Three Gorges University, Yichang 443003, People's Republic of China. E-mail:
Saudi Med J. 2014 Jan;35(1):44-9.
To determine the median effective dose (ED50) for motor block of intrathecally administered different concentrations of bupivacaine in younger patients.
This study was conducted at the Department of Anesthesiology, The First College of Clinical Medical Science, China Three Gorges University, China, on 40 American Society of Anaesthesiologists (ASA) I-II younger patients (18-40 years) undergoing lower limb surgery. These patients were classified into 2 groups according to a computer-generated random number table (Group A - 0.375% bupivacaine, and Group B - 0.75% bupivacaine). Spinal anesthesia was established by bolus administration of various up-and-down doses of 0.375%, or 0.75% plain bupivacaine. These up-and-down doses were determined by Dixon's up-and-down method. The first patient of each group was given 7.5 mg bupivacaine, and the testing interval was set at 0.75 mg. The dose was up, or down, 0.75 mg increments according to the failure or success of the preceding patient's motor block. The degree of motor block after intrathecal administration of bupivacaine was evaluated by the modified Bromage and Hip motor function score. The ED50 were estimated from the up-down sequences using the method of Dixon and Massey.
Our results showed that ED50 for motor block of intrathecal bupivacaine was 8.890 mg in Group A, and 9.998 mg in Group B, and the relative motor blocking potency ratio was 1.12.
The ED50 for motor block of intrathecally administered bupivacaine with higher concentration was slightly higher than that of a lower concentration.
确定鞘内注射不同浓度布比卡因对年轻患者运动阻滞的半数有效剂量(ED50)。
本研究在中国三峡大学第一临床医学院麻醉科进行,纳入40例接受下肢手术的美国麻醉医师协会(ASA)I-II级年轻患者(18 - 40岁)。根据计算机生成的随机数字表将这些患者分为2组(A组 - 0.375%布比卡因,B组 - 0.75%布比卡因)。通过推注不同上下剂量的0.375%或0.75%布比卡因原液建立腰麻。这些上下剂量由Dixon上下法确定。每组的第一名患者给予7.5 mg布比卡因,测试间隔设定为0.75 mg。根据前一名患者运动阻滞的失败或成功情况,剂量以0.75 mg的增量增加或减少。鞘内注射布比卡因后的运动阻滞程度通过改良的Bromage和髋关节运动功能评分进行评估。使用Dixon和Massey方法从上下序列估计ED50。
我们的结果显示,A组鞘内布比卡因运动阻滞的ED50为8.890 mg,B组为9.998 mg,相对运动阻滞效能比为1.12。
鞘内注射较高浓度布比卡因的运动阻滞ED50略高于较低浓度布比卡因。