Tai Yan-Lei, Peng Li, Wang Ying, Zhao Zi-Jun, Li Ya-Nan, Yin Chun-Ping, Hou Zhi-Yong, Shao De-Cheng, Zhang Ya-Hui, Wang Qiu-Jun
Department of Anesthesiology, Third Hospital Affiliated to Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Department of Anesthesiology, Tangshan Gongren Hospital, Tangshan, Hebei, People's Republic of China.
J Pain Res. 2022 Jun 7;15:1647-1657. doi: 10.2147/JPR.S357750. eCollection 2022.
Femoral nerve block combined with general anesthesia is commonly used for patients undergoing knee arthroscopy in ambulatory care centers. An ideal analgesic agent would selectively (differentially) block sensory fibers, with little or no effect on motor nerves. Ropivacaine is considered to cause less motor block than others. This study investigated the median effective concentration (EC) of ropivacaine for differential femoral nerve block in adults either younger or older than 60 years.
Patients with American Society of Anesthesiologists physical status I-III and scheduled for knee arthroscopy were categorized as 18- to 60-years-old (Group 1), or older than 60 years (Group 2). Surgeries were performed under general anesthesia combined with femoral nerve block via 22 mL ropivacaine. The EC of ropivacaine for differential femoral nerve block was determined using the up-and-down method and probit regression. The primary outcome was the EC (95% confidence interval [CI]) of the 2 groups. Data on the sensory block, analgesic effect, complications, and hemodynamics during surgery were also recorded.
The EC of 22 mL ropivacaine for differential femoral nerve block of Group 1 (0.124%, 95% CI 0.097-0.143%) was significantly higher than that of Group 2 (0.088%, 95% CI 0.076-0.103%). The sensory block and hemodynamic data of the 2 groups were comparable. None of the patients experienced neurological complications.
The EC of ropivacaine administered for differential femoral nerve block during knee arthroscopy was lower in patients older than 60 years, relative to younger adults.
在门诊护理中心，股神经阻滞联合全身麻醉常用于接受膝关节镜检查的患者。理想的镇痛剂应选择性（差异性）阻断感觉神经纤维，对运动神经影响很小或没有影响。罗哌卡因被认为比其他药物引起的运动阻滞更少。本研究调查了罗哌卡因用于60岁及以下或60岁以上成年人差异性股神经阻滞的半数有效浓度（EC）。
美国麻醉医师协会身体状况分级为I-III级且计划进行膝关节镜检查的患者被分为18至60岁组（第1组）或60岁以上组（第2组）。手术在全身麻醉联合通过22 mL罗哌卡因进行股神经阻滞下进行。使用上下法和概率回归确定罗哌卡因用于差异性股神经阻滞的EC。主要结局指标是两组的EC（95%置信区间[CI]）。还记录了手术期间的感觉阻滞、镇痛效果、并发症和血流动力学数据。
第1组22 mL罗哌卡因用于差异性股神经阻滞的EC（0.124%，95% CI 0.097-0.143%）显著高于第2组（0.088%，95% CI 0.076-0.103%）。两组的感觉阻滞和血流动力学数据具有可比性。所有患者均未出现神经并发症。
与年轻成年人相比，60岁以上患者在膝关节镜检查期间进行差异性股神经阻滞时罗哌卡因的EC较低。
