复合异丙酚时舒芬太尼抑制维吾尔族患者气管插管心血管反应的半数有效效应室靶浓度

Median effective target effect-site concentration of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with propofol in patients of Uygur nationality

目的确定复合异丙酚时舒芬太尼抑制维吾尔族患者气管插管心血管反应的半数有效效应室靶浓度（EC50）。方法全身麻醉下择期手术的维吾尔族患者31例，年龄21－59岁，性别不限，BMI18～28kg／rn2，ASA分级I或Ⅱ级。麻醉诱导：靶控输注异丙酚，效应室靶浓度为3．0μg／ml，静脉注射顺阿曲库铵0．2mg／kg，靶控输注舒芬太尼，第1例患者效应室靶浓度为0．8ng／ml，待效应室靶浓度与血浆靶浓度达平衡后行气管插管，发生气管插管心血管反应时，则下一例患者采用高一级浓度，否则采用低一级浓度，浓度梯度的比值为1．1。发生气管插管心血管反应的标准：收缩压升高幅度超过基础值15％和（或）心率〉90次／min且持续时间〉15S。采用Probit概率回归法计算舒芬太尼抑制气管插管心血管反应的EC。及其95％可信区间。结果复合异丙酚时舒芬太尼抑制维吾尔族患者气管插管心血管反应的Ec，。及其95％可信区间为0．46（0．43～0．49）ng／ml。结论复合异丙酚时，舒芬太尼抑制维吾尔族患者气管插管心血管反应的EC50为0．46ng／ml。

Objective To determine the median effective target effect-site concentration （EC50） of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with propofol in patients of Uygur nationality. Methods Thirty-one ASA I or II Uighurs of both sexes, aged 21-59 yr, with body mass index 18-28 kg/m2, undergoing elective surgery, were enrolled in this study. Anesthesia was induced and maintained with 0 propofol and sufentanil target-cont,＇oiled infusion and iv injection of cisatracurium 0.2 mg/kg. The target effect-site concentration （Ce） of propofol was set at 3.0 μg/ml. Tracheal intubation was performed after the target Ce and plasma concentrations were balanced. The target Ce was set at 0.8 ng/ml in the first patient. Each time Ce increased/decreased by 10% in the next patient depending on whether or not the cardiovascular response to tracheal intubation occurred. The positive cardiovascular response was defined as increase in systolic blood pressure by 15% and/or HR 〉 90 bpm lasting for 〉 15 s. The ECso （95% confidence interval） of sufentanil blunting cardiovascular responses to traneheal intnbation was calculated by Probit analysis. Results ECs0 （95 % confidence interval） of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with 3.0 μg/ml propofo] was 0.46 （0.43-0.49） ng/ml. Conclusion ECs0 of snfentanil inhibiting cardiovascular response to tracheal intubation is 0.46 ng/ml in patients of Uygur nationality when combined with propofol.