术前焦虑对丙泊酚抑制胃镜检查术内脏性疼痛EC_(50)的影响

The influence of preoperative anxiety on popofol EC_(50) for no-movement during gastroscopy

目的探讨术前焦虑对丙泊酚抑制胃镜检查术内脏性疼痛的半数有效效应室靶浓度(EC_(50))的影响。方法选择拟全身麻醉下行胃镜检查术患者,年龄30~55岁,体质指数18~30 kg/m2,ASAⅠ~Ⅱ级。根据焦虑自评量表评分将患者分为两组:焦虑组(A组)与非焦虑组(C组)。按序贯法采用Marsh药代动力学参数靶控输注丙泊酚,第l例患者血浆靶浓度设为5.00μg/mL,相邻靶浓度梯度0.50μg/mL。若出现体动反应者,下一例采用高一级浓度,否则采用低一级浓度。用概率单位法确定丙泊酚EC_(50)及其95%可信区间。结果 A组丙泊酚EC_(50)为6.46μg/mL,95%可信限为6.01~6.91μg/mL;C组丙泊酚EC_(50)为5.75μg/mL,95%可信限为5.15~6.34μg/mL,两组间比较差异有统计学意义(P<0.05);两组间不良反应的发生率,比较差异无统计学意义(P>0.05)。结论术前焦虑因素可明显降低丙泊酚的抑制胃镜检查术内脏性疼痛的效应。

Objective To investigate whether the median（50%）effective effect-concentration（EC_（50））ofpropofol inducing loss of consciousness（LOC） varies. Methods 56 patients undergoing gastroscopy undergeneral anaesthesia were enrolled on the study. Anaesthesia was conducted with a target-controlled infusion（TCI）of propofol. The initial target effect-site propofol concentration（Ceprop） was 5.00 μ g/m L and was adjustedstepwise by 0.50 μg/m L by an up-down sequential method to reach no-movement. Results Propofol EC_（50） to induceno-movement was higher in patients with anxiety than those without anxiety（6.46 μg/m L vs. 5.75 μg/m L,P 0.05）.Conclusions During general anaesthesia,patients with anxiety had a higher propofol EC_（50） for no-movementcompared with those without anxiety. Differences in preoperative anxiety levels may reduce anaesthetic effects.