麻醉诱导时靶控输注丙泊酚抑制插入喉罩反应的半数有效浓度

Half-effective concentration of target-controlled infusion propofol inhibiting the insertion reaction of the laryngeal mask airway

目的全身麻醉诱导时靶控输注(TCI)丙泊酚抑制插入喉罩反应的血浆半数有效浓度(EC50)。方法择期手术需插入喉罩患者25例,麻醉诱导时丙泊酚的初始靶浓度为4.0μg/ml,依次降低丙泊酚靶浓度,各相邻比率为1∶1。以出现插喉罩阳性反应的上一级为入选本研究的第1例,共20例患者纳入本研究统计分析。按Dixon′s序贯法调节丙泊酚的血浆靶控浓度:如果出现插喉罩阳性反应,则使用上一级浓度;如果阴性反应,则使用下一级浓度。结果插入喉罩时TCI丙泊酚的EC50为2.43μg/ml,95%可信区间为2.05～2.89μg/ml。结论设定合适的浓度,靶控输注丙泊酚插入喉罩的麻醉方法是安全有效的,可减少麻醉诱导引起的不良反应,降低麻醉的风险。

Objective To determine the EC50 of target-controlled infusion propofol during the insertion of LMA. Methods Twenty-five patients were scheduled for operation with LMA anesthesia. The initial concentration of propofol was 4.0 μg/ml. Reducing the concentration of propofol in sequence. The ratio between adjacent levels was 1：1. If the patient appeared intubation response, the previous one was selected as the first case. Twenty patients were included in this study. The plasma concentration of target-controlled propofol was determined by the method of Dixon＇s sequential. If LMA were inserted, the previous concentration was selected~ otherwise, the next level of concentration was selected. Results EC50 of target-controlled infusion propofol was 2.43 μg/ml, 95% confidence interval was 2.05-2.89 μg/ml. Conclusion TCI device for propofol with LMA may be safely and effectively with appropriate concentration under general anesthesia. This method can reduce the adverse offect of anesthesia induction and the anesthsia risk.