舒芬太尼预防罗库溴铵诱发肢体退缩反应EC_(50)测定

Determination EC_(50) of sufentanyl in preventing rocuronium induced withdrawal movements

目的：测定舒芬太尼抑制罗库溴铵注射痛引起的肢体退缩反应的半数有效效应室浓度（EC50）。方法：ASAⅠ级择期全身麻醉患者53例按性别分为男性和女性组,其中男27例,女26例。采用丙泊酚（Marsh模型）联合舒芬太尼（Bovill模型）靶控输注（TCI）,在丙泊酚的效应室浓度达到平衡后,根据序贯法输注舒芬太尼,首例患者舒芬太尼浓度从0.15 ng/mL开始,间隔浓度为0.02 ng/mL调整。舒芬太尼达到效应室浓度后给罗库溴铵0.8 mg/kg静脉注射。结果：序贯法测得男性和女性舒芬太尼EC50值分别为（0.080±0.023）、（0.103±0.019）ng/mL,概率回归分析测得EC50值分别为0.071 ng/mL[95%可信区间（0.051~0.085）ng/mL]和0.098 ng/mL[95%可信区间（0.085~0.108）ng/mL];EC95值分别为0.103 ng/mL[（0.087~0.195）ng/mL]和0.120 ng/mL[（0.109~0.176）ng/mL],女性EC50显著高于男性。结论：舒芬太尼TCI可抑制罗库溴铵诱发肢体退缩反应,且抑制退缩反应的EC50存在性别差异。

AIM： To determine the effect-site target concentration（Ce） of sufentanyl at which there was 50% probability of preventing movement from pain in response to the injection rocuronium（EC50）.METHODS： Fifty-three ASA Ⅰ patients scheduled for general anesthesia were divided into male group（n=27） and femal group（n=26）according gender.Anesthesia was induced with a propofol target-controlled infusion（TCI Marsh model） and sufentanyl TCI（Bovill model）.Effect-site target concentration of propofol was 2.8 μg/mL.Ce of sufentanyl for the first patient started st 0.15 ng/mL.Ce of sufentanyl for each subsequent patient by the Dixon up-and-down method with an interval of 0.02 ng/mL.After both drugs reached target concentration,rocuronium 0.8 mg/kg was administered and the pain response wan observed.RESULTS：The EC50 of sufentanly for preventing rocuronium induced withdrawal movements was（0.080±0.023）,（0.103±0.019） ng/mL,respectively in male group and female group.From probit analysis,the EC50 of sufentanly in male group and female group was 0.071 ng/mL（95% confidence limits 0.051-0.085 ng/mL）,0.098 ng/mL（95% confidence limits 0.085-0.108 ng/mL）and the EC95 was 0.103 ng/mL（95% confidence limits 0.087-0.195 ng/mL）,0.120 ng/mL（95% confidence limits 0.109-0.176 ng/mL）.EC50 of sufentanly was significant higher in female group than that in male group.CONCLUSION： It is effective to prevent the movement from pain in response to the injection rocuronium with sufentanyl by TCI,and EC50 of sufentanly is significant higher in female patients than that in male patients.