瑞芬太尼抑制老年患者拔管期间呛咳的半数有效血浆靶浓度

Effective target plasma concentration of remifentanil required to suppress cough during tracheal extubation in 50% elderly patients

目的测定瑞芬太尼抑制老年患者术后拔管期间呛咳的半数有效血浆靶浓度(CP50)。方法择期行咽喉部手术的老年男性患者26例,年龄65～84岁,全麻苏醒拔管期TCI瑞芬太尼,瑞芬太尼血浆靶浓度按序贯法确定,初始靶浓度为5ng/ml,相邻靶浓度之比为1.2。待血浆浓度与效应室浓度平衡时开始拔管。观察患者有无呛咳反应。结果瑞芬太尼抑制拔管期间呛咳反应的CP50为1.76ng/ml,95%可信区间(CI)为1.62～1.88ng/ml。结论老年患者咽喉部手术后瑞芬太尼抑制拔管期间呛咳反应的CP50为1.76ng/ml。

Objective To determine the effective required to suppress cough during tracheal extubation in target plasma concentration of remifentanil elderly patients. Methods Twenty-six ASA I or II grade male patients, aged 65-84yr, undergoing elective throat surgery were enrolled in this study. Remifentanil was administered at a target plasma concentration of 5 ng/ml during tracheal extubatior~ Cps0 was determined by up and down sequential trial, and the ratio of two dose plasma concentrations was 1.2. Extubation was performed when the plasma concentration and effecvsite concentration reached a balance, and incidence of cough was recorded. Results The Cp^0 of remifentanil was 1.76 ng/ml （95% confidence interval 1.62-1.88 ng/ml）. Conclusion Our study shows that a target plasma concentration of remifentanil of 1.76 ng/ml was effective in preventing cough at extubation in 50% of elderly patients undergoing throat surgery.