乳腺癌根治术硬膜外麻醉中布比卡因的最低有效和最佳浓度的临床研究

The Minimal and Optimal Concentration of Bupivacaine for Epidural Anesthesia in Mastectomy

摘要: 目的研究布比卡因用于硬膜外麻醉行乳腺癌根治手术时的最低有效浓度和最佳浓度。方法ASAⅠ~Ⅱ级择期拟行乳腺癌根治术的病人75例,T2~3穿刺,向头端置管3.5~4cm。布比卡因浓度用序贯方法配制,浓度从0.20%~0.07%,试验剂量均为5ml,观察5min,确认导管在硬膜外腔后,给予相应浓度的布比卡因20~25ml,用针刺法观察镇痛效果和麻醉平面。术中常规给氧、监测血压、心率、氧饱和度、呼吸及血气等。结果在乳腺癌根治术硬膜外麻醉中布比卡因的最低有效浓度即EC50为0.09%。其95%置信区间为0.087%~0.098%。最佳浓度为0.14%。结论乳腺癌根治术胸段硬膜外麻醉中采用布比卡因最佳浓度0.14%,(25±5)ml。可获得安全、有效的麻醉效果。

Abstract: Objective To determine the minimal and optimal concentration of Bupivacaine for epidural block in mastectomy. Methods Seventy five patients for mastectomy, classified as level ⅠorⅡ in terms of ASA evaluation, will be operated under epidural anesthesia with Bupivacaine. We puncture from T_ 2-3 and leave the tube in the epidural cavity ranged from 3.5 cm to 4cm toward the head. Different concentrations of Bupivacaine, range from 0.20% to 0.07%, are accessed by sequential dilution. We test initially with 5ml ...