依托咪酯诱发非颅内疾病患者脑电爆发抑制的半数有效剂量

Median effective dose of etomidate inducing electroencephalogram burst suppression in patients with non-intracranial diseases

目的确定依托咪酯诱发非颅内疾病患者脑电爆发抑制(BS)的半数有效剂量(ED50)。方法择期非颅内疾病患者,性别不限,年龄18~64岁,ASA分级Ⅰ或Ⅱ级,体重指数19~27 kg/m^2。采用序贯法进行试验。静脉泵注依托咪酯,初始剂量为0.30mg/kg,注射时间30s,记录注射完毕后6 min内爆发抑制率(BSR),发生BS时,下一例患者降低一个剂量梯度;否则升高一个剂量梯度。相邻剂量差值为0.05 mg/kg。发生BS标准:BSR>10%,持续时间>1min。采用Probit法计算依托咪酯诱发非颅内疾病患者脑电BS的ED50及其95%置信区间(95%CI)。结果依托咪酯诱发非颅内手术患者脑电BS的ED50为0.70mg/kg,95%CI为0.65~0.81mg/kg。结论依托咪酯诱发非颅内疾病患者脑电BS的ED50为0.70 mg/kg。

Objective To determine the median effective dose(ED50)of etomidate inducing electroencephalogram(EEG)burst suppression(BS)in the patients with non-intracranial diseases.Methods American Society of Anesthesiologists physical statusⅠorⅡpatients of both sexes,aged 18-64 yr,with body mass index of 19-27 kg/m^2,scheduled for elective non-intracranial surgery,were enrolled in this study.ED50 of etomidate was determined by Dixon′s up-and-down sequential method.Etomidate was intravenously injected for 30 s at an initial dose of 0.30 mg/kg.The BS ratio was recorded within 6 min following the end of injection.Each time ED50 increased/decreased in the next patient depending on whether or not BS occurred.The difference between the two successive doses was 0.05 mg/kg.Successful induction of BS was defined as BS ratio>10%,lasting more than 1 min.Probit analysis was used to calculate the ED50 and 95%confidence interval of etomidate inducing EEG BS in the patients with non-intracranial diseases.Results The ED50 of etomidate inducing EEG BS was 0.70 mg/kg,and the 95%confidence interval was 0.65-0.81 mg/kg in the patients with non-intracranial diseases.Conclusion The ED50 of etomidate inducing EEG BS is 0.70 mg/kg in the patients with non-intracranial diseases.