摘要
目的确定复合右美托咪定时丙泊酚抑制病人置人喉罩反应的半数有效血浆靶浓度（EC50）。方法择期全麻病人，性别不限，年龄20～60岁，体重指数20～25kg／m2，ASA分级I或Ⅱ级，采用改良Dixon序贯法进行试验。静脉输注右美托眯定1．0μg／kg，输注时间10min，随后靶控输注丙泊酚，初设血浆靶浓度3．0μg／ml，当丙泊酚效应室浓度与血浆浓度达平衡，BIS值达50-60时置入喉罩。根据是否发生喉罩置人反应确定下1例病人的异丙酚靶浓度，浓度梯度0．2μg／ml。发生置人喉罩反应的标准为出现咳嗽、体动、喉痉挛或全身有意识的体动。计算复合右美托咪定时丙泊酚抑制病人置人喉罩反应的Ec50及其95％可信区间（95％CI）。结果复合右美托咪定1．0μg／kg时丙泊酚抑制病人置入喉罩反应的Ec50及其95％cI为2．351（1．737～2．600）肛g／ml。结论复合右美托咪定1．0μg／kg时丙泊酚抑制病人置入喉罩反应的Ec50为2．351μg／ml。
Objective To determine the median effective target plasma concentration （EC50） of propofol inhibiting the response to laryngeal mask airway （LMA） insertion when combined with dexmedetomidine. Methods ASA Ⅰ or Ⅱ patients of both sexes, aged 20-60 yr, with body mass index 20-25 kg/m2 , scheduled for surgeries under general anesthesia, were studied. E C50 of propofol was determined by modified Dixon＇s up-and-down sequential experiment. After dexmedetomidine 1.0 μg/kg was infused over 10 min, propofol was infused by targetcontrolled infusion. The initial target plasma concentration of propofol was set at 3.0μg/ml. LMA was inserted when the target effect-site concentration of propofol and target plasma concentration of propofol reached the balance and BIS value was 50-60. Each time the target concentration increased/decreased by 0.2 μg/ml according to the occurrence of the response to LMA insertion. The response to LMA insertion was defined as the occurrence of coughing, body movement, laryngospasm or systemic voluntary movement. EC50 and 95 % confidence interval （CI） of propofol for inhibition of the response to LMA insertion were calculated. Results The ECs0 of propofol required for inhibition of the response to LMA insertion was 2.351 （95% CI 1.737-2.600） μg/ml when combined with dexmedetomidine 1：0μg/kg.Conclusion The EC50 of propofol inhibiting the response to LMA insertion is 2.351 μg/ml when combined with dexmedetomidine.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2012年第10期1179-1181,共3页
Chinese Journal of Anesthesiology
