鞘内注射等比重左旋布比卡因与芬太尼联合用于经尿道切除术的半数有效剂量（ED50）和95%有效剂量（ED95）：随机双盲试验

ED50 and ED95 of intrathecal isobaric levobupivacaine coadministered with fentanyl for transurethral resections: randomized, double-blind trial.

作者信息

Karslı N D, Subaşi D, Terzioğlu B, Turan G, Ekinci O

机构信息

Department of Anaesthesiology and Intensive Care, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.

Pharmacology and Toxicology Unit, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.

出版信息

Drug Res (Stuttg). 2015 Jan;65(1):24-9. doi: 10.1055/s-0034-1370940. Epub 2014 Mar 25.

DOI:10.1055/s-0034-1370940

PMID:24668575

Abstract

BACKGROUND

Levobupivacaine use is progressively increased for intrathecal anesthesia in transurethral resections. The aim was to determine ED(50) and ED(95) of intrathecal isobaric levobupivacaine by addition of 25 mcg fentanyl for patients undergoing transurethral resections.

METHODS

A total of 100 patients undergoing transurethral resections with ASA I-III, were randomized to groups receiving intrathecal 0.5% isobaric levobupivacaine in doses of 6, 8, 10, 12 or 14 mg in equal volumes with 25 mcg intrathecal fentanyl addition. Sensorial block level was determined by pinprick and motor block by Bromage scale.

RESULTS

Mean onset time of sensorial block in 6 mg group was significantly longer than that of sensorial block in 10 mg, 12 mg and 14 mg groups (p<0.01), 8 mg was longer than 12 mg and 14 mg (p<0.01), and 10 mg onset time of sensorial block was significantly longer than 12 mg and 14 mg (p<0.01). Mean onset time of T10 sensory level in 6 mg group was significantly longer than mean onset time of T10 sensory level in 10 mg, 12 mg and 14 mg (p<0.01), the mean onset time of T10 sensory level in 8 mg group was also significantly longer than that of 12 mg, 14 mg groups (p<0.01). ED(50) and ED(95) of levobupivacaine coadministered with 25 mcg fentanyl were 7.32 mg and 10.88 mg, respectively.

CONCLUSION

Levobupivacaine with opioid co-administration can be used in doses considerably lower than doses proposed for routine use as it is a safe drug depending on its hemodynamic effects, side effects.

摘要

背景

在经尿道前列腺切除术的蛛网膜下腔麻醉中，左旋布比卡因的使用量逐渐增加。目的是确定在接受经尿道前列腺切除术的患者中，通过添加25微克芬太尼来确定蛛网膜下腔等比重左旋布比卡因的半数有效剂量（ED50）和95%有效剂量（ED95）。

方法

总共100例ASA I-III级接受经尿道前列腺切除术的患者，被随机分为几组，分别接受鞘内注射0.5%等比重左旋布比卡因，剂量为6、8、10、12或14毫克，等体积并添加25微克鞘内注射芬太尼。感觉阻滞平面通过针刺法确定，运动阻滞通过布罗麻量表确定。

结果

6毫克组感觉阻滞的平均起效时间显著长于10毫克、12毫克和14毫克组（p<0.01），8毫克组长于12毫克和14毫克组（p<0.01），10毫克组感觉阻滞的起效时间显著长于12毫克和14毫克组（p<0.01）。6毫克组T10感觉平面的平均起效时间显著长于10毫克、12毫克和14毫克组（p<0.01），8毫克组T10感觉平面的平均起效时间也显著长于12毫克、14毫克组（p<0.01）。与25微克芬太尼联合使用的左旋布比卡因的ED50和ED95分别为7.32毫克和10.88毫克。