丙泊酚麻醉下舒芬太尼抑制气管插管反应的半数有效浓度

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1、丙泊酚麻醉下舒芬太尼抑制气管插管反应的半数有效浓度钱晓岚1张卫2阚全程3（1河南省直第三人民医院麻醉科，河南省郑州市450006；2.郑州大学第一附属医院麻醉科，河南省郑州市450052；3.郑州大学临床药理基地，河南省郑州市450052）【摘要】目的确定异丙酚靶控输注时舒芬太尼抑制气管插管反应的半数有效浓度(Ce50)。方法择期全麻手术病人，年龄30-50岁，ASAⅠ-Ⅱ级，BMI﹤30kg/m2,病人入手术室后监测生命体征，记录MAP、HR、SPO2。以效应室浓度靶控输注舒芬太尼,3分钟后给予血浆靶浓度为3μg/ml的丙泊酚，病人意识消失给予0.1mg/

2、kg的维库溴铵,肌松满意后行气管插管。舒芬太尼效应室靶浓度按序贯法确定，舒芬太尼靶控浓度从0.4ng/ml开始，相邻靶浓度之间比率为1．2，气管插管反应的标准：气管插管后2min内MAP高于基础值的15%和/或HR大于90次/分。结果3μg/ml的丙泊酚麻醉下舒芬太尼抑制气管插管反应的Ce50为0.32ng/ml，95％可信区间为0.3-0.36ng/ml。结论在复合靶控输注3μg/ml的丙泊酚时，舒芬太尼抑制气管插管反应的Ce50为0.32ng/ml。【关键词】哌啶类；插管法，气管内；药物释放系统；剂量效应关系，药物；丙泊酚Half-effecttarge

3、teffect-siteconcentrationofsufentanilbluntingcardiovascularresponsestotrachealintubationduringpropofoladministrationQIANXiao-lan,,.DepartmentofAnesthesiology,TheThirdPeopleHospitalofHenanProvince.ZHANGWei,KANQuan-cheng，.DepartmentofAnesthesiology,FirstAffiliatedHospitalofZhengzhouU

4、niversity,Zhengzhou450052,China【Abstract】ObjectiveTodeterminethehalf-effectivetargeteffect-siteconcentration(Ce50)ofsufentanilbluntingcardiovascularresponsestotrachealintubationduringpropofoladministration.MethodsASAclassⅠ-Ⅱpatientaged30-50yrwithbodyweightindex﹤30kg/m2undergoingele

5、ctivesurgeryundergeneralanesthesia wereenrolledinthisstudy.InductionofanesthesiawasinitiatedbyTCIofsufentanilatthetargeteffect-siteconcentrationwiththeBovillmodel.3minitelatter,TCIofpropofolatthetargetplasmaconcentrationof3μg/ml.began.Afterthelossofconsciousness,vecuronium0.1mg/kgw

6、asadministrated.Targeteffect-siteconcentrationofsufentanilwasdeterminedbyupanddownsequentialtest,Theinitialconcentrationwassetat0.4ng/ml.Theratiooftwosuccessivetargeteffect-siteconcentrationwas1.2.CardiovascularresponsesweredefinedasanincreaseinMAP≥15%and/orHR＞90/minwithin2minafter

7、intubation.ResultsTheCe50ofsufentanilwas0.32ng/ml.95%confidenceintervalwasbetween0.3ng/mland0.36ng/ml.ConclusionTheCe50ofsufentanilbluntingcardiovascularresponsestotrachealintubationis0.32ng/mlduringpropofolanesthesiaand95%confidenceintervalisbetween0.3ng/mland0.36ng/ml.【Keywords】P

8、iperidines;Intubation,intr