性别因素对复合右美托咪定时舒芬太尼抑制患者气管插管反应的影响

Effect of gender factor on sufentanil-induced inhibition of responses to endotracheal intubation when combined with dexmedetomidine

目的评价性别因素对复合右美托咪定时舒芬太尼抑制患者气管插管反应的影响。方法气管插管全麻下择期手术患者,ASA分级Ⅰ或Ⅱ级,年龄18~64岁,BMI<30 kg/m^2,根据性别分为男性组(M组)和女性组(F组)。静脉输注右美托咪定0.4μg/kg 5 min。10 min后TCI丙泊酚3μg/ml和舒芬太尼。2组初始舒芬太尼靶浓度为0.35 ng/ml,根据是否发生气管插管反应确定下一例舒芬太尼靶浓度,相邻靶浓度比值为1.2。采用序贯法计算舒芬太尼抑制气管插管反应的半数有效浓度(EC50)及95%可信区间。结果M组26例,F组28例。M组EC50(95%可信区间)为0.2640(0.2409~0.2893)ng/ml;F组EC50(95%可信区间)为0.1589(0.1382~0.1826)ng/ml。F组EC50低于M组(P<0.05)。结论复合右美托咪定时,舒芬太尼抑制气管插管反应的效应存在性别差异。

Objective To evaluate the effect of gender factor on sufentanil-induced inhibition of responses to endotracheal intubation when combined with dexmedetomidine.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 18-64 yr,with body mass index<30 kg/m^2,undergoing elective surgery under general anesthesia requiring tracheal intubation,were divided into 2 groups according to gender:male group(group M)and female group(group F).Dexmedetomidine 0.4μg/kg was intravenously infused over 5 min,and 10 min later propofol 3μg/ml and sufentanil were given by target-controlled infusion.In the two groups,the initial target concentration of sufentanil was set at 0.35 ng/ml in the first case,the target concentration of sufentanil in the next case was determined according to whether responses to endotracheal intubation occurred,and the ratio between the two consecutive target concentrations was 1.2.The median effective concentration(EC50)and 95% confidence interval(CI)of sufentanil inhibiting responses to endotracheal intubation were determined by Dixon's up and down sequential trial.Results There were 26 cases in group M and 28 cases in group F.The EC50(95%CI)of sufentanil was 0.2640(0.2409-0.2893)ng/ml in group M.The EC50(95%CI)of sufentanil was 0.1589(0.1382-0.1826)ng/ml in group F.The EC50 of sufentanil was significantly lower in group F than in group M(P<0.05).Conclusion Gender-related differences exist in sufentanil-induced inhibition of responses to endotracheal intubation when combined with dexmedetomidine.