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you mei tuo zuo zuo ju bu yong yao dui zuo bu bi ka yin chao sheng yin dao xia zuo shen jing zu zhi ban shu you xiao nong du de ying xiang
Author(s): 
Pages: 85-86
Year: Issue:  1
Journal: Chinese Journal of Postgraduates of Medicine

Keyword:  右美托咪啶神经传导阻滞胫神经剂量效应关系药物左布比卡因;
Abstract: 目的:评价右美托咪啶局部用药对左布比卡因超声引导下胫神经阻滞半数有效浓度(EC50)的影响。方法拟在超声引导下胫神经阻滞下行跟骨手术患者40例,ASA分级Ⅰ或Ⅱ级,采用随机数字表法将其分为两组左布比卡因组(L组)和左布比卡因混合右美托咪啶组(LD组),每组20例。采用B超联合神经刺激器引导定位,行术侧胫神经阻滞,分别局部注射左布比卡因(L组)或左布比卡因与20μg右美托咪啶混合液(LD组)20 ml,左布比卡因初始浓度0.35%,按序贯法确定下一例左布比卡因浓度,相邻浓度比值为1.2。采用Dixon-Massey法计算左布比卡因EC50及95%CI。结果 LD组左布比卡因胫神经阻滞EC50明显低于L组[0.31%(95%CI 0.29%~0.32%)比0.43%(95%CI 0.39%~0.45%)],差异有统计学意义(P<0.05)。两组均未发生低血压、镇静过度、呼吸抑制或局部麻醉药中毒等不良反应。LD组有2例发生一过性心动过缓,1例无需治疗,另1例用阿托品后纠正;L组无心动过缓发生。结论局部应用小剂量右美托咪啶可对左布比卡因胫神经阻滞产生显著的强化作用。
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