舒芬太尼对Supreme喉罩置入反应效应室浓度的影响

Effect-site concentration of sufentanil for Supreme laryngeal mask airway insertion

目的测定丙泊酚靶控输注时舒芬太尼抑制女性患者Supreme喉罩置入反应的效应室靶浓度。方法择期妇科手术患者20例,年龄20～50岁,设定舒芬太尼效应室浓度行靶控输注,3 min后以效应室浓度4.0 mg/L靶控输注丙泊酚。舒芬太尼的效应室靶浓度按改良序贯法确定,待两种药物血浆浓度与效应室浓度达到平衡且脑电双频指数(BIS)值<60时置入喉罩,记录血流动力学变化及有无喉罩置入反应。结果丙泊酚靶控输注时舒芬太尼抑制Su-preme喉罩置入反应的半数效应室靶浓度(EC50)为0.182μg/L,95%CI为(0.079～0.232)μg/L;EC95为0.249μg/L,95%CI为(0.212～0.865)μg/L。结论无肌松条件下丙泊酚效应室浓度4.0 mg/L靶控输注时,舒芬太尼抑制女性患者Supreme喉罩置入反应的EC50为0.182μg/L。

Objective To determine the effect-site concentration of sufentanil and provide optimal conditions for successful Supreme laryngeal mask airway insertion during target-controlled infusion（TCI） of propofol in female patients.Methods Twenty patients aged 20~50 years undergoing elective gynecological surgery were enrolled in this study.Sufentanil was infused at a concentration determined by modified Dixon′s up-and-down method,three minutes after sufentanil infusion,TCI of propofol was started at target effect-site concentration of 4.0 μg/ml.After achieving the balance between the plasma and effect-site concentration of the two drugs and bispectral index（BIS） 60,the Supreme laryngeal mask was inserted by the same anesthetist.The target effect-site concentration of sufentanil at which the laryngeal mask were inserted successfully in 50% or 95% of the patients（EC50 or EC95） and respective 95% confidence interval（CI） was determined by Probit method.Results There was no neuromuscular blockade during TCI of 4.0 μg/ml propofol,the EC50 and EC95 of sufentanil were 0.182 ng/ml（95% CI 0.079~0.232 ng/ml） and 0.249 ng/ml（95% CI 0.212~0.865 ng/ml）,respectively.Conclusion The EC50 of effect-site concentration of sufentanil is 0.182 ng/ml without neuromuscular blockade combined with TCI of 4.0 μg/ml propofol in female patients.