Research of median effective dose of levobupivacaine for ultrasound -guided transversus abdominis plane block in pediatric hernia surgery / 中国基层医药

ABSTRACT

Objective To investigate the median effective dose of levobupivacaine for ultrasound -guided transversus abdominis plane ( TAP ) block in pediatric hernia surgery .Methods Thirty consecutive children scheduled for pediatric hernia surgery were treated by basic anesthesia and ultrasound -guided TAP block .The levobupivacaine dose for a particular patient was determined by the response of the previous patient to a higher or smaller dose (step size of 0.1mg/kg) using Dixon's up-and-down sequential method,starting at levobupivacaine 0.5mg/kg.Block failure was defined as a 20％ increase in heart rate ( HR) or mean arterial pressure ( MAP) from baseline .The ED50 and 95％confidence interval ( CI) of levobupivacaine were calculated by the Dixon's up-and-down method and logistic regression analysis .Results The ED50 and 95％CI of levobupivacaine for TAP block obtained by Dixon's up-and-down sequential method were 0.24(0.22～0.27)mg/kg,the ED50 and 95％CI of levobupivacaine obtained through the probit test were 0.17(0.08～0.24)mg/kg.Adverse effects related to TAP block were not found in all children who underwent herniorrhaphy .Conclusion Ultrasound-guided TAP block can reduce local analgesic dosis and adverse effects ,the ED50 of levobupivacaine for ultrasound -guided TAP block in pediatric hernia surgery is 0.24mg/kg.