【摘要】 目的测定腋路臂丛置管用于屈肌腱功能锻炼时左旋布比卡因的最低局麻药镇痛浓度(MLAC)。方法选择40例ASAⅠ或Ⅱ级行屈肌腱松解的择期手术患者,采用神经刺激器导管技术(B.Braun)行腋鞘置管。术后24～48h进行功能锻炼前经导管推注20ml左旋布比卡因,30min后进行VAS评分(包括静止和锻炼时)。采用阶梯方法,局麻药的起始浓度为0.1%。如锻炼时VAS评分≤10mm,则下一病例降低局麻药浓度0.01%;如锻炼时VAS评分>10mm,则下一病例增加局麻药浓度0.01%。同时观察运动功能阻滞程度。结果屈肌腱松解术后主动锻炼时,腋路20ml左旋布比卡因臂丛神经阻滞的MLAC为0.127%(95%CI,0.119%～0.135%);6例(17%)患者运动神经被部分阻滞。结论在屈肌腱松解术后主动运动镇痛中,腋路20ml左旋布比卡因臂丛神经阻滞的MLAC为0.127%。更多还原

【Abstract】 Objective To study and assess the minimum local analgesic concentration (MLAC) of levobupivacaine for continuous axillary brachial plexus block in active mobilization of flexor tendon. Methods 40 ASA physical statusⅠor Ⅱpatients who were underwent flexor tendon relaxation were selected. A catheter was placed into axillary sheath using B.Braun stimulating introducer. 30 min before active mobilization, 20ml levobupivacaine were injected through the catheter. The initial concentration of local anesthetic was 0.1%. The cansequent concentration of local anesthetic was determined based on the response of the precede patient and the concentration was increased and decreased in a sequential manner. The analgesic efficacy was assessed using 100-mm visual analogue scale, with 10mm or less defined as effective. An effective result was used to direct a 0.01% wt/vol decrement for the next patient. Greater than 100-mm VAS, an ineffective result was used to direct a 0.01% wt/vol increment. At the sametime, motor block was observed . Results The minimum local analgesic concentration of levopivacaine was 0.127% wt/vol (95% CI, 0.119%～0.135%), Motor never was incompletely blocked in 6 patients. Conclusions This study shows that the minimum local analgesic concentration of levobupivacaine is 0.127% wt/vol (95% CI, 0.119%～0.135%).更多还原