靶控丙泊酚下抑制高血压病患者气管插管心血管反应的舒芬太尼半数有效浓度

EC50 of sufentanil under targeted controlled propofol for Inhibition of cardiovascular responses to hypertension patients

目的探讨抑制高血压病患者气管插管时心血管反应的舒芬太尼半数有效靶浓度。方法选择我院择期手术患者,患者经三级甲等医院明确诊断高血压病,规律服用抗高血压药药物,现血压控制正常,免术前用药,入室后开放外周静脉通路,连接监护仪,桡动脉测压,按序贯法用靶控输注泵泵人舒芬太尼,相邻浓度比值1.2,舒芬太尼到达靶控浓度后靶控输注异丙酚3.5 ug/ml,给予顺式阿曲库铵0.3 mg/Kg后气管插管,记录诱导及插管的血压、心率。结果高血压病患者的舒芬太尼抑制气管插管反应的半数有效靶浓度是0.21ng/ml,95%的可信区间（CI）为0.19~0.24 ng/ml。结论对于高血压病人群,使用靶控丙泊酚3.5 ug/ml麻醉诱导时,舒芬太尼抑制气管插管反应的半数有效浓度为0.21ng/ml。

Objective To evaluate Medium effective concentration （EC50） of sufentanil under the control of Targeted propofol for Inhibition of cardiovascular responses to hypertension patients. Methods ASAⅠ-Ⅱpatients undergoing elective surgery were enrolled in this study.The patients were diagnosed with hypertension in the three level of first-class hospital and regularly used of antihypertensive drugs to maintain normal blood pressure . The patients were unpremedicated and monitor was connected, the following procedure was done Into the operating room including opening peripheral venous access and radial artery pressure measurement. Sufentanil was injected into patients through a target-controlled infusion pump according to the sequential method with a Interval of the concentration ratio of 1.2. Then 3.5 ？g/ml propofol and 0.3mg/Kg of atracurium were infused individually before tracheal intubation was done. The blood pressure and heart rate were recorded.Results EC50 of sufentanil was 0.21ng/ml for Inhibition of cardiovascular responses to hypertension patients. CI was between 0.19 to 0.24 ng/ml. Conclusion For the hypertension patients, EC50 of sufentanil to prevent cardiovascular response in tracheal intubation was 0.21ng/ml when 3.5ug/ml targeted and controlled propofol was used to do anesthesia induction.