丙泊酚靶控输注时舒芬太尼抑制视频喉镜插管的效应室浓度

Effect-site concentration of sufentanil blunting responses to tracheal intubation with video laryngoscope during propofol TCI

目的：探讨丙泊酚靶控输注（TCI）时舒芬太尼抑制视频喉镜气管插管反应的效应室靶浓度（EC50和EC95）。方法 择期全麻手术患者23例，以效应室浓度TCI舒芬太尼，3min后给予血浆靶浓度为3 μg／mL丙泊酚，给予顺式阿曲库铵O．15mg／kg行视频喉镜气管插管。舒芬太尼效应室靶浓度按改良序贯法增加或减少0．05ng／mL，舒芬太尼靶控浓度从0．4ng／mL开始。结果：舒芬太尼抑制视频喉镜气管插管反应的EC为0．32ng／mL．95％可信区间（C1）为O．29～0．35ng／mL；相应的ECZ为0．38ng／mL，95％CI为0．35—0．55ng／mL。结论：在复合TCI丙泊酚5μg／mL时，舒芬太尼抑制视频喉镜气管插管反应的ECZ和EC95分别为0．32ng／mL和0．38ng／mL。

Objective To deter mine the effect-site concentration of sufentanil blunting responses to tracheal intubation with video laryngoscope during propofol target controlled infusion （TCI）. Methods Twenty-three patients undergoing selective surgery under general anesthesia were enrolled in this study. Induction of anesthesia was initiated by TCI sufentanil at the target effect-site concentration 3 min later, TCI of propofol began at the target plasma concentration of 3 μg/mL. Cisatracurium 0.15 mg/kg was ad ministrated for video laryngoscope tracheal intubation after loss of consciousness. The target concentration of sufentanil for consecutive patients was deter mined using the modified Dixon＇s up-and-down method by the intubation response of the previous patient, in an increment or decrement of 0.05 ng/mL. The initial concentration was set at 0.4 ng/mL. Results The ECS0 of Sufentanil was 0.32 ng/mL with 95% confidence interval of 0.29 - 0.35 ng/mL; the EC95 was 0.38 ng/mL with 95% confidence interval 0.35-0.55 ng/mL during video laryngoscope tracheal intubation. Conclusion The EC50 and EC95of sufentanil blunting responses to tracheal intubation with video laryngoscope are 0.32 ng/mL and 0.38 ng/mL during propofol TCI.