|
|
|
| The median effective dosage of 0.447% Methansulfonic Ropivacaine for ultrasound-guided infraclavicular brachial plexus nerve block |
| ZHANG Yinghui1 XI Zilong2 HAN Yunyun3 YI Jingdong4 |
1.Department of Anesthesia, the Fifth People′s Hospital of Hengshui City, Hebei Province, Hengshui 053000, China;
2.Department of Orthopaedics, the Fifth People′s Hospital of Hengshui City, Hebei Province, Hengshui 053000, China;
3.Department of Ultrasound, the Fifth People′s Hospital of Hengshui City, Hebei Province, Hengshui 053000, China;
4.Department of Lnternal Medicine, the Fifth People′s Hospital of Hengshui City, Hebei Province, Hengshui 053000, China |
|
|
|
Abstract Objective To determine the median effective dosage of 0.447% Methansulfonic Ropivacaine for ultrasound-guided infraclavicular brachial plexus nerve block. Methods From December 2015 to December 2017, 100 cases carried out upper limb surgery in Anesthesia Department of the Fifth People's Hospital of Hengshui City were selected, ASA Ⅰ-Ⅲ level. Subclavian brachial plexus nerve block guided by ultrasound was carried out, in ultrasonic axillary arteriovenous screen real-time imaging, at brachial plexus inside (outside, behind) lateral band, ribs, pleura, chest muscle groups such as size, 0.447% Methansulfonic Ropivacaine was injected after successfull positioning. Dixon sequential method (Up-and-Down) experiment, with 0.447% Methansulfonic Ropivacaine, and 20 mL solution for the initial capacity, if the block effect was complete, reduce 2 mL to the next patient; if the block effect was incomplete, increase 2 mL to the next patient, and so on. Dixon sequential formula was used to calculate the median effective dosage of 0.447% Methansulfonic Ropivacaine and 95% confidence interval (95%CI) in subclavian brachial plexus nerve block guided by ultrasound. Results Upper limb in patients with subclavian brachial plexus nerve block guided by ultrasound, the median effective dosage of 0.447% Methansulfonic Ropivacaine and 95%CI of 17.5 (17.0-18.0) mL. Conclusion 0.447% Methansulfonic Ropivacaine, for patients with upper limb subclavian brachial plexus nerve block guided by ultrasound, median effective dosage is 17.5 mL.
|
|
|
|
|
|
[1] 叶伦辉，石宗莉，陈莉，等.超声定位下行锁骨下喙突入路臂丛麻醉的效果及安全性[J].贵州医科大学学报，2016， 41（12）：1470-1473.
[2] 党丹丹，谢致，车薛华.地佐辛超前镇痛用于锁骨下臂丛神经阻滞的效果评价[J].中华临床医学，2014，21（6）：668-670.
[3] 吴友冈，孙朗荣，杨玉华.神经刺激仪引导下喙突入路锁骨下臂丛神经阻滞不同定位法比较[J].现代医药卫生，2014，32（16）：2216-2217.
[4] Dingemans E，Willianms SR，Arcand G，et al. Neurostimulation in ultrasound-guided infraclavicular block：a prospective randomized trial [J]. Anesth Analg，2007，104（5）：1275-1280.
[5] 吴川，王秀丽，刘朋.神经刺激器引导下喙突旁锁骨下臂丛神经阻滞的效果[J].临床麻醉学杂志，2015，31（1）：92-93.
[6] 支燕，谢红，马吉宁，等.不同容量局部麻醉药用于超声引导锁骨下臂丛神经阻滞的效果比较[J].中国医师进修杂志，2014，37（32）：31-33.
[7] 冷亚妃.垂直锁骨下臂丛神经阻滞两种穿刺点定位方法的比较[J].医学信息，2014，11：234.
[8] 王义凤，杨昌明，王伶俐，等.超声引导行喙突旁入路与腋入路臂丛神经阻滞效应的比较[J].北京医学，2015，37（8）：749-751.
[9] 江琦，杨进辉，周丽华，等.神经刺激器定位锁骨下臂丛后束与外束神经阻滞临床效应的观察[J].广东医学，2017， 38（10）：1542-1544.
[10] 李锴，邓孔立，江莫星，等.神经刺激定位垂直锁骨下臂丛神经阻滞的临床观察[J].湘南学院学报：医学版，2013， 15（3）：47-49.
[11] 武茜，田伟千，郑曼，等.超声引导锁骨下臂丛神经阻滞不同入路的临床效果[J].临床麻醉学杂志，2016，32（11）：1087-1090.
[12] Fredrickson MJ，Wolstencroft P，Kejriwal R，et al. Single versus triple injection ultrasound-guided infraclavicular block：confirmation of the effectiveness of the single injection technique [J]. Anesth Analg，2010，111（5）：1325-1327.
[13] 张颖辉，伊敬东，韩云云.0.4%罗哌卡因用于超声引导腋路臂丛神经阻滞的半数有效量[J].河北医科大学学报，2011，32（10）：1160-1162.
[14] Taboada M，Rodriguez J， Valifio C，et al. What is the minimum effective volume of local anesthetic required for sciatic nerve blockade? A prospective，randomized comparison between a popliteal and a subgluteal approach [J]. Anesth Analg，2006，102：593-597.
[15] 顾晨桃，王爱忠，江伟.甲磺酸罗哌卡因和盐酸罗哌卡因肌间沟臂丛神经阻滞的比较[J].临床麻醉学杂志，2009， 25（11）：940-942.
[16] 廖志敏，张晋峰，张兰，等.甲磺酸罗哌卡因与盐酸罗哌卡因用于神经阻滞麻醉的临床效果比较[J].四川医学，2007，28（10）：940-942.
[17] 李西宽，焦亚奇，刘俊田，等.甲磺酸罗哌卡因局麻作用的实验研究[J].中国药理学通报，2004，20（2）：236-237.
[18] 张玮玮，杨云萍，陈强，等.在神经刺激仪引导下比较锁骨下和锁骨上臂丛神经阻滞的临床效果[J].山西医药杂志，2014，43（13）：1570-1572.
[19] 刘莹，袁嫕，周雁，等.连续锁骨下臂丛神经阻滞用不同浓度罗哌卡因于肘关节松解手术后镇痛效果的差异[J].中国医刊，2014（10）：77-80.
[20] 廖俊，王庚，张晓光.超声联合神经刺激引导逆行锁骨下与锁骨上臂丛阻滞的比较[J].实用医学杂志，2012， 28（18）：3092-3094.
[21] 袁嫕，刘莹，刘雪冰，等.自控锁骨下臂丛神经阻滞用于患者肘关节松解术后镇痛的效果[J].中华麻醉学杂志，2015，35（11）：1296-1299.
[22] 王秀珍，葛叶盈，叶光耀，等.自控锁骨下臂丛神经阻滞对肘关节三联征术后镇痛及手术疗效的影响[J].中国骨伤，2017，30（11）：1029-1033.
[23] 张海清，丁庆民.超声引导下不同径路臂丛神经阻滞的应用进展[J].医学综述，2016，22（18）：3659-3662. |
|
|
|
