复合阿芬太尼时环泊酚在不同性别患者中抑制气管插管反应的半数有效剂量

Median effective dose of ciprofol combined with alfentanil to inhibit tracheal intubation response in patients with different gender

目的测定复合阿芬太尼时环泊酚在不同性别患者中抑制气管插管反应的半数有效剂量(ED 50)。方法选择择期插管全麻下行甲状腺切除术的患者56例,年龄18~64岁,BMI 18.5~28.0 kg/m^(2),ASAⅠ或Ⅱ级。根据性别将患者分为两组:男性组(M组,n=31)和女性组(F组,n=25)。静脉注射环泊酚,待BIS≤60或改良警觉/镇静评分(MOAA/S评分)≤1分后,依次静注阿芬太尼30μg/kg、罗库溴铵0.6 mg/kg,1 min后插入气管导管。气管插管阳性反应定义为气管插管过程中患者出现呛咳或插管后2 min内MAP或HR升高幅度大于基础值的20%。根据改良Dixon序贯法进行试验,设定环泊酚初始剂量为0.4 mg/kg,相邻剂量梯度为1∶1.1,采用Probit概率法计算复合阿芬太尼时环泊酚在不同性别患者中抑制气管插管反应的ED 50、95%有效剂量(ED 95)及95%可信区间(CI)。结果M组环泊酚复合阿芬太尼时抑制气管插管反应的ED 50为0.311 mg/kg(95%CI 0.278~0.338 mg/kg),ED 95为0.380 mg/kg(95%CI 0.349~0.530 mg/kg);F组环泊酚复合阿芬太尼时抑制插管反应的ED 50为0.242 mg/kg(95%CI 0.172~0.279 mg/kg),ED 95为0.324 mg/kg(95%CI 0.284~0.665 mg/kg)。结论复合阿芬太尼时环泊酚在男性和女性患者中抑制气管插管反应的ED 50分别为0.311 mg/kg和0.242 mg/kg。

Objective To determine the median effective dose(ED 50)of ciprofol combined with alfentanil to inhibit tracheal intubation response in patients with different gender.Methods Fifty-six patients,aged 18-64 years,BMI 18.5-28.0 kg/m^(2),ASA physical statusⅠorⅡ,who underwent elective thyroidectomy under intubation general anesthesia,were selected and divided into two groups based on gender:the male group(group M,n=31)and the female group(group F,n=25).After intravenous injection of ciprofol,BIS≤60 or the modified observer s assessment of alertness and sedation(MOAA/S)score≤1,alfentanil 30μg/kg and rocuronium 0.6 mg/kg were successively injected,1 minute later,the endotracheal tube was inserted.The positive reaction of tracheal intubation was defined as that the patient choked during the process of intubation or the MAP or HR increased by more than 20%of the base value within 2 minutes after intubation.The trial was conducted according to the modified Dixon sequential method,with an initial dose of ciprofol 0.4 mg/kg and an adjacent dose gradient of 1∶1.1.The Probit analysis was used to calculate the ED 50,95%effective dose(ED 95),and 95%confidence interval(CI)of the inhibition of tracheal intubation response in patients with different gender when ciprofol combined with alfentanil.Results In group M,the ED 50 of inhibition of tracheal intubation response by combination of ciprofol and alfentanil was 0.311 mg/kg(95%CI 0.278-0.338 mg/kg),and ED 95 was 0.380 mg/kg(95%CI 0.349-0.530 mg/kg).In group F,the ED 50 for inhibition of tracheal intubation response was 0.242 mg/kg(95%CI 0.172-0.279 mg/kg)and the ED 95 was 0.324 mg/kg(95%CI 0.284-0.665 mg/kg)when combined with alfentanil.Conclusion Combined with alfentanil,the ED 50 of ciprofol inhibiting tracheal intubation response in male and female patients are 0.311 mg/kg and 0.242 mg/kg respectively.