舒芬太尼靶控输注对七氟醚抑制气管插管反应ED_(50)的影响

Effect of target-controlled concentrations of sufentanil on sevoflurane to prevent tracheal intubation response ED_(50)

目的研究舒芬太尼靶控输注对七氟醚抑制气管插管反应最低肺泡浓度ED50的影响。方法40例ASAI级，择期妇科手术患者随机分为舒芬太尼靶浓度0．5ng／ml＋七氟醚吸入组（SS组）和七氟醚吸入对照组（S组）。舒芬太尼靶浓度和七氟醚呼出浓度稳定于预先设定值20min后气管插管。七氟醚抑制气管插管反应最低肺泡浓度ED50测定方法采用医学序贯试验中的上-下法。结果SS组七氟醚抑制气管插管反应最低肺泡浓度ED50为0．99％，95％可置区间为0．85％-1．14％，S组分别为4．59％和4．30％～4．89％。结论舒芬太尼靶控输注可明显降低七氟醚抑制气管插管反应最低肺泡浓度ED50。

Objective To study the effect of target-controlled concentrations of sufentanil （0.5 ng/ml） on the sevoflurane requirement to prevent tracheal intubation response. Methods Forty patients with American Society of Anesthesiologists physical status I were anesthetized with vecuronium and sevoflurane. Then, patients were randomly allocated to receive no sufentanil infusion or a target-controlled plasma concentration of 0.5 ng/ml. Sympathetic responses to tracheal intubation were determined after a 20 min period of stable end-tidal sevoflurane and target-controlled sufentanil concentrations. Predetermined end-tidal sevoflurane concentrations and the ED50 in each group were determined by the mean of up-and-down sequential-allocation technique. Results The ED50 of sevoflurane to prevent tracheal intubation response in group which receiving a target-controlled plasma concentration of sufentanil （0.5 ng/ml） was 0.99%. The 95% confidence interval was 0.85% to 1.14%. The ED50 of sevoflurane to prevent tracheal intubation response in group which receiving no remifentanil was 4.59%. The 95% confidence interval was 4.30% to 4.89%. Conclusion A target-controlled concentration of 0. 5 ng/ml sufentanil results in a signficant decrease in the ED50 of sevoflurane requirement to prevent tracheal intubation response.