Effect of dexmedetomidine on the median effective concentration of ropivacaine during sciatic nerve block combined with femoral nerve block in patients undergoing lower extremity surgery
10.12173/j.issn.1005-0698.202410098
- VernacularTitle:右美托咪定对下肢手术患者坐骨神经阻滞联合股神经阻滞时罗哌卡因半数效应浓度的影响研究
- Author:
Zuquan CHEN
1
;
Xiaoping GU
;
Wenjun ZOU
;
Fuqiang HE
Author Information
1. 四川省第四人民医院麻醉科(成都 610000)
- Publication Type:Journal Article
- Keywords:
Dexmedetomidine;
Ropivacaine;
Sciatic nerve block;
Femoral nerve block;
Median effective concentration
- From:
Chinese Journal of Pharmacoepidemiology
2025;34(4):380-390
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of dexmedetomidine on the median effect concentration(EC50)of ropivacaine during sciatic nerve block combined with femoral nerve block in patients undergoing lower extremity surgery.Methods Patients with sciatic nerve block combined with femoral nerve block anesthesia who underwent lower extremity surgery from November 2021 to November 2023 were selected as the study objects.They were randomly divided into control group(0.9％saline),group D1(0.50 μg·kg-1 dexmedetomidine),group D2(0.75 μg·kg-1 dexmedetomidine)and group D3(1.00 μg·kg-1 dexmedetomidine).The stress response,serum pain mediators,vital signs and visual analogue scale(VAS)of patients at different time points during operation were analyzed by repeated measures ANOVA.ropivacaine EC50 was measured by sequential method,and the relationship between dexmedetomidine dose and ropivacaine EC50 was analyzed by Logistic regression.Results A total of 208 patients were include and each group was 52 patients.Compared with the same group before surgery,the stress response level of the 4 groups after surgery and 1 h after surgery was significantly decreased,and the serum pain mediators level was significantly increased(P＜0.05).Compared with the control group,the stress response and serum pain mediators levels in groups D1,D2 and D3 were more normal after surgery and 1 h after surgery,among them,group D3 was most close to the normal value(P＜0.05).There were no significant differences in blood oxygen saturation and bifrequency index of EEG among the four groups at each time point(P＞0.05).At T1 and T2,the heart rate(HR)of the control group was significantly higher than that of the group D2 and D3(P＜0.05).At T1,the control group had a significantly higher mean arterial pressure(MAP)than the other three groups,at T2,the control group had a significantly higher MAP than the group D2 and D3,and at T3,the control group had a significantly higher MAP than the group D3(P＜0.05).VAS scores in 4 groups were significantly lower after surgery and 1 h after surgery than before surgery(P＜0.05).The VAS score in group D3 was significantly lower than that in group D1 and D2(P＜0.05).Repeated measurement ANOVA showed that the effects of time on stress response and serum pain mediators were different with different anesthesia methods.The influence of time on HR,MAP and VAS scores varied with different anesthesia methods.Sequential assay results showed that the EC50 of ropivacaine in control group,group D1,group D2 and group D3 was 5.985,5.631,5.329 and 5.125 μg·mL-1,respectively.Logistic results showed that the dose of dexmedetomide was a protective factor for ropivacaine EC50 in sciatic nerve block combined with femoral nerve block in limb surgery patients(P＜0.05).Conclusion The ropivacaine EC50 can be significantly reduced by 1.00 μg·kg-1 dexmedetomidine.This is a protective factor for sciatic nerve block combined with femoral nerve block in patients undergoing lower limb surgery,and it can be applied clinically.
