复合丙泊酚时阿芬太尼抑制患儿无痛皮肤磨削术中体动反应的半数有效剂量

Median effective dose of alfentanil combined with propofol for inhibiting intraoperative motor responses in children undergoing painless dermabrasion

目的探讨复合丙泊酚时阿芬太尼抑制患儿无痛皮肤磨削术中体动反应的半数有效剂量(ED_(50))。方法选择2021年7—11月择期行无痛皮肤磨削术患儿24例,男11例,女13例,年龄5~10岁,BMI 12~20 kg/m^(2),ASAⅠ或Ⅱ级。所有患儿均给予丙泊酚2 mg/kg复合阿芬太尼静脉麻醉。采用Dixon序贯法进行研究,阿芬太尼初始剂量10μg/kg,下一例患儿剂量由上一例患儿体动反应决定,若术中体动反应阳性,下一例患儿阿芬太尼剂量增加1μg/kg;若术中体动反应阴性,则下一例患儿阿芬太尼剂量减少1μg/kg,重复此过程直到出现7个拐点终止研究。采用Probit法计算阿芬太尼的ED_(50)、95%有效剂量(ED_(95))及其95%可信区间(CI)。结果复合丙泊酚时阿芬太尼抑制体动反应的ED_(50)为9.58μg/kg(95%CI 8.97~10.21μg/kg),ED_(95)为10.74μg/kg(95%CI 10.12~14.01μg/kg)。结论复合丙泊酚2 mg/kg时阿芬太尼用于患儿无痛皮肤磨削术的ED_(50)为9.58μg/kg(95%CI 8.97~10.21μg/kg)。

Objective To evaluate the median effective dose(ED_(50))of alfentanil combined with propofol for inhibiting intraoperative motor responses in children undergoing painless dermabrasion.Methods Twenty-four children undergoing painless dermabrasion were selected from July 2021 to November 2021,11 males and 13 females,aged 5-10 years,BMI 12-20 kg/m^(2),ASA physical statusⅠorⅡ.Propofol 2 mg/kg combined with alfentanil was given in all children undergoing painless dermabrasion.The dose of alfentanil was determined by the Dixon up-down method,the initial dose of alfentanil was 10μg/kg.The dose of alfentanil in the next child was determined according to the development of body-moving.If body-moving occurred,the next case was given a higher-level dose(add alfentanil 1μg/kg),if body-moving did not occurred,the next case was given a lower-level dose(reduce alfentanil 1μg/kg),repeat this process until the seventh exchange point appeared to completed the study.The ED_(50),95%effective dose(ED_(95))and 95%confidence interval(CI)of alfentanil combined with propofol in children undergoing painless dermabrasion were calculated using Probit method.Results The ED_(50) of alfentanil combined with propofol was 9.58μg/kg(95%CI 8.97-10.21μg/kg),and the ED_(95) of alfentanil combined with propofol was 10.74μg/kg(95%CI 10.12-14.01μg/kg)in children undergoing painless dermabrasion.Conclusion The ED_(50) of alfentanil combined with propofol 2 mg/kg were 9.58μg/kg(95%CI 8.97~10.21μg/kg)in children undergoing painless dermabrasion.