艾司氯胺酮在不同性别输尿管支架取出术患者中的有效剂量研究

Study oneffective dose of esketamine in different genderpatients undergoing ureteral stenting

目的研究不同性别患者在输尿管支架取出术中艾司氯胺酮达到满意麻醉效果时的半数有效剂量(Median effective dose,ED50)和95%有效剂量(95%Effective dose,ED95)。方法以2023年1月-2023年4月在海安市中医院麻醉科行内镜下输尿管支架取出术的48例患者为研究对象,根据患者性别分为男性25例(A组),女性23例(B组)。两组艾司氯胺酮初始剂量为0.5 mg/kg体重,根据患者对麻醉效果的满意情况,运用Dixon′s up-and-down序贯法确定下一例患者使用剂量,直至出现第7个交换点(麻醉效果由满意转换为不满意)即停止试验。计算两组ED50、ED95和95%置信区间(95%CI)。结果A组和B组的ED50分别为0.41 mg/kg体重(95%CI:0.30~0.47)和0.32 mg/kg体重(95%CI:0.26~0.35);A组和B组的ED95分别为0.54 mg/kg体重(95%CI:0.48~1.30)和0.38 mg/kg体重(95%CI:0.35~0.66)。结论艾司氯胺酮可以安全地应用于输尿管支架取出术,能有效缓解输尿管支架取出造成的疼痛。

Objective To observe the median effective dose(ED 50)and 95%effective dose(ED 95)of esketamine to achievesatisfactory anesthetic effect for ureteral stent removal in different genderspatients.MethodsFrom January 2023 to April 2023,48 patients who underwent endoscopic ureteral stent removal in the Anesthesiology Department of the hospital were selected as study subjects.According to the gender of the patients,25 patients were male(group A)and 23 patients were female(group B).The initial dose of Ketamine in the two groups was 0.5mg/kg body weight.According to the patients′satisfaction with the anesthetic effect,Dixon′s up-and-down sequential method was used to determine the dose of the next patient,and the trial was stopped until the seventh exchange point(the anesthetic effect was changed from satisfactory to unsatisfactory)appeared.Calculatedthe two sets of ED 50,ED 95 and 95%confidence intervals(95%CI).ResultsThe ED 50 in Group A and Group B was 0.41 mg/kg(95%CI:0.30~0.47)and 0.32 mg/kg(95%CI:0.26~0.35)respectively.ED 95 was 0.54 mg/kg(95%CI:0.48~1.30)and 0.38 mg/kg(95%CI:0.35~0.66)respectively.ConclusionsEsketamine can be safely used in ureteral stent removal and can effectively relieve the pain caused by ureteral stent removal.