无肌松药诱导插入经典喉罩时丙泊酚效应室浓度

Effect-site concentration of propofol for classic laryngeal mask airway insertion during target-controlled infusion without neuromuscular relaxant

目的测定无肌松药诱导插入经典喉罩丙泊酚靶控输注(TCI)的半数有效浓度(Ce50)。方法择期全麻腹腔镜胆囊切除术患者25例。采用改良序贯法确定丙泊酚效应室靶浓度,初始血浆靶浓度设定为6.0μg/ml,梯度为0.2μg/ml。待丙泊酚血浆靶浓度和效应室浓度平衡时插入喉罩。用概率单位回归法计算丙泊酚Ce50和Ce95及其95%可信区间(CI)。结果丙泊酚Ce50为5.49μg/ml,95%CI为4.99～5.75μg/ml;Ce95为6.07μg/ml,95%CI为5.78～10.75μg/ml。结论无肌松药诱导插入喉罩丙泊酚TCI的Ce50为5.49μg/ml,Ce95为6.07μg/ml。

Objective To determine the effect-site concentration of propofol without neuromuscular relaxant for successful classic laryngeal mask airway （CLMA） insertion response in 500% and 95% of patients（Ce50 and Ce95 ）during a target-controlled infusion （TCI）. Methods Twenty- five patients were scheduled for general anesthesia for laparoscopic cholecystectomy. The effect-site concentration of propofol was determined using the modified Dixon＇s up-and-down method. Anesthesia was induced with propofol during a target-controlled infusion at a plasma concentration of 6.0μg/ml （0. 2 μg/ml as a step size）. After equilibrium between the plasma and effect-site concentration of propofol, the CLMA was inserted. Changes of intraoperative hemodynamic were recorded. Probability analysis was used for calculating Ce50, Ce95 and corresponding 95% confidence interval（CI）. Results The Ce50 of propofol was 5.49 μg/ml（95%CI 4.99-5.75 μg/ml）and Ce95 of propofol was 6.07μg/ml（95%CI 5.78-10. 75μg/ml）. Conclusion The Ce50 and Ce95 of propofol for insertion of the CLMA during TCI without neuromuscular relaxant were 5.49μg/ml and 6.07 pg/ml, respectively.