PDF(Pubmed)
Abstract：
UNASSIGNED: Alterations in altitude can lead to an augmented requirement for local anesthesia among patients. Nevertheless, the necessity for an elevated dosage of local anesthetic for parturients at moderately high altitudes during spinal anesthesia for cesarean section remains uninvestigated. This up-down sequential study endeavors to determine the ED50 dose of bupivacaine required for spinal anesthesia during cesarean sections at moderately high-altitude.
UNASSIGNED: Thirty singleton parturients at moderately high altitude underwent elective cesarean section under combined spinal-epidural anesthesia. The up-and-down sequential method was employed, starting with an initial dose of 12mg (1.6mL) of 0.75% hyperbaric bupivacaine for the first participant. The dose for the next case was adjusted up or down by 0.75mg based on the effectiveness of the previous participant. Effectiveness was defined as the bilateral sensory block reaching T6 within 15 minutes after spinal anesthesia injection, without the need for additional epidural anesthesia before fetal delivery. The ED50 dose and 95% confidence interval were calculated using the Dixon sequential method and isotonic regression, respectively. The incidence of maternal hypotension, nausea, and vomiting during the study period was also recorded.
UNASSIGNED: The ED50 of hyperbaric bupivacaine for spinal anesthesia in cesarean section was calculated as 8.23 mg (95% CI, 6.52-9.32 mg) using the Dixon up-and-down method. Further validation using isotonic regression yielded a value of 8.39 mg (95% CI, 7.48-9.30 mg), confirming the accuracy and sensitivity of the conclusion. During the operation, only 6 parturients experienced hypotension, and no adverse reactions such as nausea, vomiting, and shivering were observed.
UNASSIGNED: The ED50 dose of 0.75% hyperbaric bupivacaine for spinal anesthesia during cesarean section at moderately high altitude is 8.23 mg, which exceeds the ED50 dose typically required by parturients at low altitude. Comprehensive investigations are warranted to ascertain the ED90 or ED95 dose of local anesthetics for cesarean section at moderately high altitudes, thereby offering enhanced guidance for clinical practice.
UNASSIGNED: Thirty singleton parturients at moderately high altitude underwent elective cesarean section under combined spinal-epidural anesthesia. The up-and-down sequential method was employed, starting with an initial dose of 12mg (1.6mL) of 0.75% hyperbaric bupivacaine for the first participant. The dose for the next case was adjusted up or down by 0.75mg based on the effectiveness of the previous participant. Effectiveness was defined as the bilateral sensory block reaching T6 within 15 minutes after spinal anesthesia injection, without the need for additional epidural anesthesia before fetal delivery. The ED50 dose and 95% confidence interval were calculated using the Dixon sequential method and isotonic regression, respectively. The incidence of maternal hypotension, nausea, and vomiting during the study period was also recorded.
UNASSIGNED: The ED50 of hyperbaric bupivacaine for spinal anesthesia in cesarean section was calculated as 8.23 mg (95% CI, 6.52-9.32 mg) using the Dixon up-and-down method. Further validation using isotonic regression yielded a value of 8.39 mg (95% CI, 7.48-9.30 mg), confirming the accuracy and sensitivity of the conclusion. During the operation, only 6 parturients experienced hypotension, and no adverse reactions such as nausea, vomiting, and shivering were observed.
UNASSIGNED: The ED50 dose of 0.75% hyperbaric bupivacaine for spinal anesthesia during cesarean section at moderately high altitude is 8.23 mg, which exceeds the ED50 dose typically required by parturients at low altitude. Comprehensive investigations are warranted to ascertain the ED90 or ED95 dose of local anesthetics for cesarean section at moderately high altitudes, thereby offering enhanced guidance for clinical practice.
摘要：
■海拔高度的改变会导致患者对局部麻醉的需求增加。然而，在剖宫产术的脊髓麻醉期间，在中等高海拔地区的产妇中增加局部麻醉药剂量的必要性仍未研究。这项上下顺序研究试图确定中度高海拔剖宫产期间脊髓麻醉所需的布比卡因的ED50剂量。
■30例中高海拔单胎产妇在腰硬联合麻醉下进行择期剖宫产。采用上下顺序法，从初始剂量为12mg(1.6mL)的0.75%的高压布比卡因开始。下一个病例的剂量根据先前参与者的有效性上调或下调0.75mg。有效性定义为脊髓麻醉注射后15分钟内双侧感觉阻滞达到T6，无需在胎儿分娩前进行额外的硬膜外麻醉。使用Dixon序贯方法和等渗回归计算ED50剂量和95%置信区间,分别。产妇低血压的发生率，恶心,并记录了研究期间的呕吐。
■使用Dixon上下法计算剖宫产腰麻的高压布比卡因的ED50为8.23mg（95％CI，6.52-9.32mg）。使用等渗回归的进一步验证得出的值为8.39mg（95％CI，7.48-9.30mg），证实了结论的准确性和敏感性。在操作过程中,只有6例产妇出现低血压,无恶心等不良反应,呕吐,并观察到颤抖。
■0.75%高压布比卡因用于中度高海拔剖宫产腰麻的ED50剂量为8.23mg，超过低空产妇通常需要的ED50剂量。有必要进行全面调查，以确定中度高海拔地区剖宫产的局部麻醉药的ED90或ED95剂量。从而为临床实践提供更好的指导。
■30例中高海拔单胎产妇在腰硬联合麻醉下进行择期剖宫产。采用上下顺序法，从初始剂量为12mg(1.6mL)的0.75%的高压布比卡因开始。下一个病例的剂量根据先前参与者的有效性上调或下调0.75mg。有效性定义为脊髓麻醉注射后15分钟内双侧感觉阻滞达到T6，无需在胎儿分娩前进行额外的硬膜外麻醉。使用Dixon序贯方法和等渗回归计算ED50剂量和95%置信区间,分别。产妇低血压的发生率，恶心,并记录了研究期间的呕吐。
■使用Dixon上下法计算剖宫产腰麻的高压布比卡因的ED50为8.23mg（95％CI，6.52-9.32mg）。使用等渗回归的进一步验证得出的值为8.39mg（95％CI，7.48-9.30mg），证实了结论的准确性和敏感性。在操作过程中,只有6例产妇出现低血压,无恶心等不良反应,呕吐,并观察到颤抖。
■0.75%高压布比卡因用于中度高海拔剖宫产腰麻的ED50剂量为8.23mg，超过低空产妇通常需要的ED50剂量。有必要进行全面调查，以确定中度高海拔地区剖宫产的局部麻醉药的ED90或ED95剂量。从而为临床实践提供更好的指导。
