复合羟考酮时丙泊酚抑制无痛胃镜患者体动反应的ED50/ED95

ED50 and ED95 of oxycodone combined with propofol for inhibiting spontaneous movement in patients undergoing painless gastroscopy

目的确定复合羟考酮时丙泊酚抑制无痛胃镜患者体动反应的量效关系。方法选取2016年7月在海南省人民医院内镜中心择期行无痛胃镜检查患者60例,按随机数字表法分为丙泊酚组(P组)和羟考酮复合丙泊酚组(OP组),每组30例,两组再各自分六个亚组。P组患者先静脉注射生理盐水2 mL后,各亚组分别静脉推注丙泊酚2.2 mg/kg、2.4 mg/kg、2.6 mg/kg、2.8 mg/kg、3.0 mg/kg、3.2 mg/kg,药物注射时间为40 s;OP组患者先静脉注射羟考酮2 mg(2 mL)后,各亚组后分别给予异丙酚1.4 mg/kg、1.6 mg/kg、1.8 mg/kg、2.0 mg/kg、2.2 mg/kg和2.4 mg/kg,给药2 min后,若患者睫毛反射消失,Bis低于65,置入胃镜无体动反应,则记为阳性病例,反之记为阴性病例,则酌情追加丙泊酚0.2~0.5 mg/kg直至患者无体动完成检查。记录每组的相应的剂量及阳性病例数。采用Probit法计算丙泊酚的ED50和ED95。结果丙泊酚抑制无痛胃镜患者体动反应的ED50为2.6(2.4~2.9)mg/kg,ED95为3.1(2.9~4.0)mg/kg,复合羟考酮2 mg时丙泊酚抑制胃镜患者体动反应的ED50为1.8(1.6~1.9)mg/kg,ED95 2.1(2.0~2.9)mg/kg。结论复合2 mg羟考酮后异丙酚的用量可以减少约30%。

Objective To investigate the dose-response relationship of oxycodone combined with propofol for inhibiting spontaneous movement in patients undergoing painless gastroscopy. Methods A total of 60 patients who un-derwent painless gastroscopy in Endoscopy Center in Hainan Provincial People＇s Hospital from July 2016 were selected. According to random number table, they were divided into two groups：propofol group （P group）, and oxycodone com-bined with propofol group （OP group）, with 30 patients in each group. The two groups were respectively divided into six subgroups. P group were treated with intravenous saline 2 mL, and then each subgroup was injected with propofol 2.2 mg/kg, 2.4 mg/kg, 2.6 mg/kg, 2.8 mg/kg, 3.0 mg/kg, 3.2 mg/kg, with a drug injection time of 40 s. Patients in OP group were first intravenously injected with oxycodone 2 mg （2 mL）, and then each subgroup was injected with propofol 1.4 mg/kg, 1.6 mg/kg, 1.8 mg/kg, 2.0 mg/kg, 2.2 mg/kg and 2.4 mg/kg. Patients were assessed in 2 minutes after the in-jections. The positive cases was defined as the eyelash reflex disappeared, BIS value below 65 and no body movement during the procedure, with conversely as negative cases （in which propofol 0.2-0.5 mg/kg was added until no body movement）. The corresponding dose and the number of positive cases were recorded in each group. The 50%effective dose （ED50） and ED95 of propofol were calculated by Probit analysis. Results The ED50 and ED95 for inhibiting spontaneous movement were respectively 2.6 （2.4-2.9） mg/kg and 3.1 （2.9-4.0） mg/kg in P group, 1.8 （1.6-1.9） mg/kg and 2.1 （2.0-2.9） mg/kg in OP group. Conclusion Dosage of propofol can be reduced by about 30%after application of 2 mg oxycodone.