七氟醚诱导无肌松下舒芬太尼抑制气管插管反应的浓度

Effect-site concentration of sufentanil for intubation during sevoflurane induction without neuromuscular blockade

目的测定七氟醚诱导无肌松条件下舒芬太尼抑制气管插管反应的效应室靶浓度(EC50和EC95)。方法选择27例ASAⅠ或Ⅱ级择期全麻手术患者,吸入8%七氟醚诱导同时靶控输注(TCI)舒芬太尼,舒芬太尼靶浓度按改良序贯法增加或减少0.02ng/ml。患者意识消失后七氟醚浓度降至5%,待舒芬太尼的血浆浓度和效应室浓度平衡1min后行气管插管。用概率单位回归法计算出舒芬太尼抑制气管插管反应的EC50、EC95及相应的95%可信区间(CI)。结果舒芬太尼抑制气管插管反应的EC50为0.325ng/ml,95%CI为0.307～0.342ng/ml;EC95为0.363ng/ml,95%CI为0.344～0.498ng/ml。结论七氟醚诱导时无肌松条件下舒芬太尼抑制气管插管反应的EC50和EC95为0.325ng/ml和0.363ng/ml。

Objective To determine the optimal dose of sufentanil for inhibiting tracheal intubation response in 50% and 95% of patients（EC50 and EC95 ） during sevoflurane induction without neuromuscular blockade. Methods Twenty seven ASA Ⅰor Ⅱ patients undergoing selective general anesthesia were inducted by sevoflurane 8% and target controlled infusion （TCI） sufentanil. At the loss of awareness, the sevoflurane reduced to 5%. One minute after equilibrium between the plasma and effect-site concentration of sufentanil, the trachea was intubated. The dose of sufentanil was determined using the modified Dixon＇s ut〉and-down method （0.02 ng/ml as a step size）. Probability analysis was used for calculating ECho, EC50 and 95% confidence interval （CI）. Results The ECso of sufentanil was 0. 325 ng/ml （95%CI was 0. 307-0. 342 ng/ml） and EC95 of sufentanil was 0. 363 ng/ ml （95%CI was 0. 344 0. 498 ng/ml）. Conclusion The EC50 and EC95 of sufentanil for intubation during sevoflurane induction without neuromuscular blockade were 0. 325 ng/ml and 0. 363 ng/ml.