七氟烷吸入诱导的性别差异

The Gender Difference of Sevoflurane Inhaled Induction

目的测定男性与女性患者七氟烷吸入诱导下气管插管的半数有效浓度(MAC-EI50)并进行统计学比较。方法择期全麻患者,男性组(M组)31例,女性组(F组)35例,呼吸回路进行七氟烷预充后行肺活量法面罩吸入,调节七氟烷吸入浓度,进行序贯法吸入,首例患者设定浓度为4%,待气体浓度吸入(Fi)与呼出(Ft)均接近或达到设定的目标浓度(Fi/Ft=1)时,静脉注射芬太尼3μg/kg+维库溴胺0.15mg/kg,2 min后进行气管插管,采用插管反应作为判断指标,出现7个交叉点(有效浓度-无效浓度)达到试验终点。结果 M组七氟烷的MAC-EI50为3.021(1.8MAC),其95%的可信区间CI为(2.208,3.520)。F组七氟烷的MAC-EI50为2.744(1.6MAC),其95%的可信区间CI为(2.358,3.093)。两组间进行u检验,P<0.05,差异有统计学意义。结论性别也是影响气管插管时气体麻醉的MAC值的一个因素,男性的MAC-EI50明显高于女性。

Objective To determine median effective concentration（MAC-EI50） of tracheal intubation with sevoflurane inhaled induction in male and female patients and conduct statistical processing.Methods There were 66 general anesthesia patients enrolled in this study,including 31 males（M group） and 35 females（F group）.After the breathing circuit was pre-charged with sevoflurane,the spirometry mask inhalation was used for the induction,and the sevoflurane concentration was adjusted for sequential inhalation.The first patient＇s concentration was set to be 4%.When the inhaled（Fi） and outbound（Ft） gas concentrations were close to or reached the set target concentration（Fi/Ft=1）,the patient was intravenously injected fentanyl 3μg/kg＋vecuronium amine 1.5μg/kg,and two minutes later,the tracheal intubation was performed.Intubation response was adopted as the judgment indicator,and the trial reached the endpoint when 7 cross points emerged（effective concentration-ineffective concentration）.Results MAC-EI50 of sevoflurane in M group was 3.021（1.8MAC）,and 95% confidence interval（CI） was（2.208,3.520）.MAC-EI50 of sevoflurane in F group was 2.744（1.6MAC）,and 95% confidence interval（CI） was（2.358,3.093）.The two groups had statistically significance（P0.05） according to u-test. Conclusion Gender is also a factor affecting the MAC value of gas anesthesia for tracheal intubation,and MAC-EI50 in men is significantly higher than women.