The Clinical Trial of the Same dose Ropivacaine after Lumbar Plexus with Sciatic Nerve Block_West China Medical Journal

Authors：

XU Hongwei , ZHOU Ji , ZHANG Jinfeng , et al

Department of Anesthesiology,West china hospital,Sichuan University,Chengdu 610041,China;

Corresponding?author：

Keywords：

羅哌卡因; 神經阻滯; 腰叢; 坐骨神經

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目的:觀察相同劑量不同濃度的羅哌卡因用于腰叢坐骨神經聯合阻滯的臨床效果。方法:擇期行單側下肢手術的患者90例,年齡18~65歲,ASAⅠ或Ⅱ級,隨機分為3組(n=30):A組給予0.3 ％的羅哌卡因腰叢36 mL、坐骨神經24 mL,B組給予0.36 ％的羅哌卡因腰叢30 mL、坐骨神經24 mL,C組給予0.4％羅哌卡因腰叢27 mL、坐骨神經18 mL。分別于給藥后2、5、10、15、20、25、30、35 min測定下肢的感覺、運動評分以及感覺阻滯的時間和運動阻滯的時間。結果:三組患者阻滯起效時間無明顯差別,高容量組完全阻滯的持續時間短于低容量組;高容量低濃度組患者完全阻滯率高于低容量組,但達到完全阻滯時間長于低容量組。結論:在劑量相同時羅哌卡因的濃度和容量會影響腰叢和坐骨神經的阻滯效果;高容量羅哌卡因更有利于達到良好的感覺阻滯。

Citation： XU Hongwei,ZHOU Ji,ZHANG Jinfeng,et al. The Clinical Trial of the Same dose Ropivacaine after Lumbar Plexus with Sciatic Nerve Block. West China Medical Journal, 2009, 24(3): 619-621. doi: Copy

1.
2.
3.	TABOADA M,ATANASSOFF PG.Lower extremity nerve block[J].Curr Opin Anaethesiol,2004,17:403-408..
4.	徐仲煌,黃宇光,潘華,等.羅哌卡因用于腰叢－坐骨神經聯合阻滯的臨床觀察[J].中華麻醉學雜志,2002,22:235-238..
5.	DHIR S,GANAPATHY S,LINDSAY P,et al.Case report:ropivacaine neurotoxicity at clinical doses in interscalene brachial plexus block[J].Can J Anaesth,2007,54:912-916..
6.	TABOADA M,ALVAREZ J,CORT?S J,et al.The effects of three different approaches on the onset time of sciatic nerve blocks with 0.75% ropivacaine[J].Anesth Analg,2004,98(1):242-247..
7.	AWAD I T,DUGGAN EM.Posterior lumbar plexus block:anatomy,approaches,and techniques[J].Reg Anesth Pain Med,2005,30:143-149..
8.	CASATI A,FANELLI G,MAGISTRIS L,et al.Minimum local anesthetic volume blocking the femoral nerve in 50% of cases:a doubleblinded comparison between 0.5% ropivacaine and 0.5% bupivacaine[J].Anesth Analg,2001,92(1):205-208..
9.	CASATI A,BACIARELLO M,DI CIANNI S,et al.Effects of ultrasound guidance on the minimum effective anaesthetic volume required to block the femoral nerve[J].Br J Anaesth,2007,98(6):823-827..
10.	ILFELD BM,LOLAND VJ,GERANCHER JC,et al.The effects of varying local anesthetic concentration and volume on continuous popliteal sciatic nerve blocks:a dualcenter,randomized,controlled study[J].Anesth Analg,2008,107(2):701-707..
11.	舒化青,張小洺,姚尚龍等.不同濃度羅哌卡因用于腰叢坐骨神經阻滯的藥代動力學[J].中華麻醉學雜志,2006,26:1018-1020..

1.
2.
3. TABOADA M,ATANASSOFF PG.Lower extremity nerve block[J].Curr Opin Anaethesiol,2004,17:403-408..
4. 徐仲煌,黃宇光,潘華,等.羅哌卡因用于腰叢－坐骨神經聯合阻滯的臨床觀察[J].中華麻醉學雜志,2002,22:235-238..
5. DHIR S,GANAPATHY S,LINDSAY P,et al.Case report:ropivacaine neurotoxicity at clinical doses in interscalene brachial plexus block[J].Can J Anaesth,2007,54:912-916..
6. TABOADA M,ALVAREZ J,CORT?S J,et al.The effects of three different approaches on the onset time of sciatic nerve blocks with 0.75% ropivacaine[J].Anesth Analg,2004,98(1):242-247..
7. AWAD I T,DUGGAN EM.Posterior lumbar plexus block:anatomy,approaches,and techniques[J].Reg Anesth Pain Med,2005,30:143-149..
8. CASATI A,FANELLI G,MAGISTRIS L,et al.Minimum local anesthetic volume blocking the femoral nerve in 50% of cases:a doubleblinded comparison between 0.5% ropivacaine and 0.5% bupivacaine[J].Anesth Analg,2001,92(1):205-208..
9. CASATI A,BACIARELLO M,DI CIANNI S,et al.Effects of ultrasound guidance on the minimum effective anaesthetic volume required to block the femoral nerve[J].Br J Anaesth,2007,98(6):823-827..
10. ILFELD BM,LOLAND VJ,GERANCHER JC,et al.The effects of varying local anesthetic concentration and volume on continuous popliteal sciatic nerve blocks:a dualcenter,randomized,controlled study[J].Anesth Analg,2008,107(2):701-707..
11. 舒化青,張小洺,姚尚龍等.不同濃度羅哌卡因用于腰叢坐骨神經阻滯的藥代動力學[J].中華麻醉學雜志,2006,26:1018-1020..

West China Medical Journal

The Clinical Trial of the Same dose Ropivacaine after Lumbar Plexus with Sciatic Nerve Block

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