摘要
目的测定丙泊酚效应室浓度（Ce）为3.5μg·mL^-1时,瑞芬太尼靶控输注（TCI）用于喉罩（LMA）成功置入的半数有效效应室浓度（Ce50）。方法按照升降序贯法连续选择病例,28例患者入选。首先设定丙泊酚Ce为3.5μg·mL^-1开始TCI,5min后以初始Ce 3.5ng·mL^-1 TCI瑞芬太尼,5min后行LMA置入术,根据LMA置入成功或失败以0.5ng·mL^-1为增减量对下一例患者的瑞芬太尼Ce进行调整,采用升降序贯试验法结合probit法计算瑞芬太尼Ce50及95%可信区间,记录患者麻醉诱导前（T0）,丙泊酚TCI后1min（T1）、3min（T2）、5min（T3）,瑞芬太尼TCI后1min（T4）、3min（T5）、5min（T6）及插入LMA后1min（T7）各时点的心率（HR）、血压（BP）及脉搏血氧饱和度（SpO2）,观察患者术后有无不良记忆。结果 1）丙泊酚Ce为3.5μg·mL^-1时,瑞芬太尼TCI用于成功置入LMA的Ce50为2.80ng·mL^-1,其95%可信区间为1.79-3.46ng·mL^-1;Ce95为4.21ng·mL^-1,其95%可信区间为3.51-11.7ng·mL^-1。术后随访患者均无麻醉诱导期不良记忆。2）与T0比较,T5、T6、T7时间点的MAP及T6、T7时间点的HR均明显下降（均P〈0.05）。T0与T1、T2及T3时间点的MAP及HR,T5、T6与T7时间点的MAP及HR比较差异均无统计学意义（均P〉0.05）。结论丙泊酚Ce 3.5μg·mL^-1 TCI时瑞芬太尼用于麻醉诱导成功置入LMA的Ce50及Ce95分别为2.80ng·mL^-1及4.21ng·mL^-1。
Objective To determine the median effective effect-site concentration（Ce50）of remifentanil for laryngeal mask airway（LMA）insertion during anesthesia induction with targetcontrolled infusion（TCI）of propofol at an effect-site concentration（Ce）of 3.5μg·mL^-1.Methods According to the up-and-down sequential allocation methodology,28patients were enrolled in this study.Remifentanil TCI（Ce,3.5ng·mL^-1）was performed 5minutes after the beginning of propofol TCI（Ce,3.5ng·mL^-1）,and LMA insertion was carried out 5minutes after the beginning of remifentanil TCI.According to the success or failure of LMA insertion,the Ce given to the next patient was adjusted with a step size of 0.5ng·mL^-1.The Ce50and 95%confidence interval（CI）of remifentanil for LMA insertion were calculated with up-and-down sequential allocation method and Probit analysis.Heart rate（HR）,blood pressure（BP）and oxygen saturation（SpO2）were recorded before anesthesia induction（T0）,1minute after propofol TCI（T1）,3minute after propofol TCI（T2）,5minute after propofol TCI（T3）,1minute after remifentanil TCI（T4）,3minute after remifentanil TCI（T5）,5minute after remifentanil TCI（T6）and 1minute after LMA insertion（T7）.In addition,bad memories were investigate postoperatively in all patients.Results The Ce50and Ce95of remifentanil were 2.80ng·mL^-1（95%CI：1.79-3.46ng·mL^-1）and 4.21ng·mL^-1（95%CI：3.51-11.7ng·mL^-1）,respectively.No patients had bad memories during anesthesia induction.Compared with T0,MAP was reduced at T5,T6and T7,and HR was decreased at T6and T7（P〈0.05）.Both MAP and HR determined at T0were not significantly different from those determined at T1,T2or T3,and those determined at T5or T6were not significantly different from those determined at T7（P〉0.05）.Conclusion The Ce50and Ce95of remifentanil for LMA insertion during anesthesia induction with TCI of propofol at a Ce of3.5μg·mL^-1 are 2.80and 4.21ng·mL^-1,respectively.
出处
《南昌大学学报（医学版）》
CAS
2014年第7期61-64,共4页
Journal of Nanchang University：Medical Sciences
关键词
半数有效效应室浓度
瑞芬太尼
丙泊酚
喉罩置入
靶控输注
median effective effect-site concentration
remifentanil
propofol
laryngeal mask airway insertion
target-controlled infusion
