左旋布比卡因在小儿骶管阻滞中的量效关系

目的 确定1～3岁小儿单次骶管阻滞时左旋布比卡因的量效关系.方法 纳入行腹股沟区择期手术小儿60例.ASA Ⅰ级,年龄1～3岁,随机分为6组,每组10例.七氟烷和50%氧化亚氮吸入诱导下进行骶管穿刺,骶管腔内用药分别为0.08%、0.10%、0.12%、0.14%、0.16%和0.18%的左旋布比卡因1 mL/kg.骶管阻滞完成后停止七氟烷和氧化亚氮吸入,静脉注射咪达唑仑0.1 mg/kg维持小儿镇静.骶管腔给药20 min后于下腹壁横纹处行外科切皮,观察切皮反应.切皮过程.小儿没有体动而且血压、心率升高＜20%,认为骶管阻滞有效.Probit检验计算50%和95%小儿骶管阻滞有效的左旋布比卡因浓度(EC50和EC95)及95%可信区间,Logistic回归分析获得左旋布比卡因的浓度-有效概率反应曲线. 结果左旋布比卡因浓度为0.08%、0.10%、0.12%、0.14%、0.16%和0.18%时,骶管阻滞有效率分别为10%、30%、60%、90%、100%和100%.结论 在0.1 mg/kg咪达唑仑镇静下,1～3岁小儿左旋布比卡因骶管阻滞50%有效浓度(EC50)为0.109%(95%的可信区间为0.098%～0.120%),95%有效浓度(EC95)为0.151%(95%的可信区间为0.135%～0.193%).

Levobupivacaine for caudal analgesia in children:a dose-response curve finding study

Objective The purpose of this dose-response study was to determine an optimum concentration of levobupivacaine for caudal analgesia in children.MethodSisty children aged 1-3 yr scheduled for inguinal minor surgery were recruited.Anesthesia was induced with Sevofurane and Nitrous Oxide via face mask.Then a caudal blockade(total volume of local anesthetic 1 mL/kg) was performed.They were randomly received one of six concentrations(0.08, 0.10, 0.12, 0.14, 0.16 or 0.18%) of Levobupivacaine.Inhalational anesthet...