复合异丙酚时舒芬太尼抑制老年患者喉罩置入反应的半数有效效应室靶浓度-论文.pdf

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1、824中华麻醉学杂志2014年7月第34卷第7期ChinJAnesthesiol，July2014，V01．34，No．7·全身麻醉·复合异丙酚时舒芬太尼抑制老年患者喉罩置入反应的半数有效效应室靶浓度刘玲李波孙健吕国义【摘要】目的确定复合异丙酚时舒芬太尼抑制老年患者喉罩置人反应的半数有效效应室靶浓度(Ec。)。方法择期全麻下经尿道前列腺电切术患者，年龄66～75岁，BMI19～30kg／m2，ASA分级I或Ⅱ级。麻醉诱导：靶控输注异丙酚，起始效应室靶浓度1~tg／ml，每隔1min靶浓度递增0．5“g

2、／ml，直至靶浓度达2／~g／ml时维持5min。同时靶控输注舒芬太尼，第1例患者效应室靶浓度为0．3ng／ml，待患者意识消失且效应室浓度与血浆浓度达平衡后行喉罩置入术，发生喉罩置人反应时，则下一例患者采用高一级浓度，否则采用低一级浓度，相邻浓度比值为1．2。发生喉罩置入反应的标准：喉罩置人术后5min内患者MAP和HR升高幅度超过基础值2O％。采用Probit法计算舒芬太尼抑制喉罩置人反应的EC。及其95％可信区间。结果复合异丙酚时舒芬太尼抑制老年患者喉罩置人反应的Ec。及其95％可信区间为0．1

3、60(0．130—0．188)ng／ml。结论复合异丙酚时舒芬太尼抑制老年患者喉罩置人反应的Ec为0．160ng／ml。【关键词】舒芬太尼；二异丙酚；老年人；剂量效应关系，药物Medianeffectivetargetefect-siteconcentrationofsufentaniiinhibitingresponsestoinsertionoflaryngealmaskairwaywhencombinedwithpropofolinelderlypatientsu，Bo，SunJian，LyuG

4、uoyi．DepartmentofAnesthesiology，SecondHospitalofTianfinMedicalUniversity，Tianfin300211，ChinaCorrespondingauthor：“Guoyi，Email：lvguoyiys@126．corn【Abstract】ObjectiveTodeterminethemedianeffectivetargeteffect—siteconcentration(EC50)ofsufentanilinhibitingresp

5、onsestoinsertionoflaryngealmaskairway(LMA)whencombinedwithpropofolintheelderlypatients．MethodsASAphysicalstatusIor1Ipatients，aged66—75yr，withbodymassindexof19-30kg／m2，scheduledforelectivetransurethralresectionofprostateundergeneralanesthesia，wereinclude

6、dinthisstudy．Anesthesiawasinducedwithpropofolgivenbytarget—controlledinfusion．Theinitialtargeteffect—siteconcentration(Ce)ofpropofolwas1fg／ml，andtheCewasincreasedby0．5／~g／mlevery1minuntilitwasincreasedto2／~g／mlandmaintainedatthislevelfor5rain．Sufentanil

7、wassimultaneouslyadministeredbytarget—controlledinfusion．ThetargetCeofsufentanilwas0．3ng／mlinthefirstpatient．TheconcentrationofsufentanilwasdeterminedusingthemodifiedDixon’sup—and·downmethod．Afterthepatientslostconsciousness，LMAwasinsertedafterthetarget

8、effect—siteandplasmaconcentrationswerebalanced．TheinsertionresponsewasdefinedaspositivewhenMAPandHRincreasedby20％ofthebaselinevaluewithin5minafterinsertionofLMA．TheCeofsufentanilwasincreased／decreasedinthenextpatientiftheinsertio