复合阿芬太尼时环泊酚抑制患者喉罩置入反应的半数有效剂量

Median effective dose of ciprofol inhibiting responses to insertion of laryngeal mask airway when combined with alfentanil

目的:确定复合阿芬太尼时环泊酚抑制患者喉罩置入反应的半数有效剂量(ED 50)。 方法:选取择期全麻手术患者,性别不限,年龄40~64岁,BMI 20~30 kg/m^(2),ASA分级Ⅰ或Ⅱ级。麻醉诱导:静脉注射咪达唑仑0.025 mg/kg,5 min后记录基础MAP和HR,取3次平均值为基础值。依次静脉注射环泊酚和阿芬太尼10 μg/kg,待BIS值<60时静脉注射罗库溴铵0.6 mg/kg,2 min后置入喉罩,行机械通气。置入喉罩后3 min内MAP最大值或HR最大值较基础值增加≥20%,或者出现体动、呛咳、皱眉、口角抽动、流泪、喉痉挛、BIS值未能下降至60以下,发生上述一种则判定为发生阳性反应。采用Dixon序贯法进行试验,环泊酚初始剂量为0.4 mg/kg,相邻剂量比为1.1,若发生阳性反应时,则下一例患者升高1个剂量梯度;否则降低1个剂量梯度。采用probit法计算环泊酚抑制患者喉罩置入反应的ED 50及其95%可信区间(95% CI)。 结果:复合阿芬太尼10 μg/kg时环泊酚抑制患者喉罩置入反应的ED 50及其95% CI为0.291(0.231~0.318) mg/kg。 结论:复合阿芬太尼时环泊酚抑制患者喉罩置入反应的ED 50为0.291 mg/kg。

Objective To determine the median effective dose(ED50)of ciprofol inhibiting responses to insertion of laryngeal mask airway in the patients when combined with alfentanil.Methods American Society of Anesthesiologists Physical Status classificationⅠorⅡpatients of either sex,aged 40-64 yr,with body mass index of 20-30 kg/m^(2),undergoing elective general anesthesia,were enrolled.Midazolam 0.025 mg/kg was intravenously injected for anesthesia induction,the baseline mean arterial pressure and heart rate were recorded 5 min later,and the average value of three times was considered as the baseline value.Ciprofol and alfentanil 10μg/kg were intravenously injected in sequence,rocuronium 0.6 mg/kg was intravenously injected when BIS value<60,2 min later a laryngeal mask airway was placed,and mechanical ventilation was performed.Positive response was defined as increase in the maximum mean arterial blood pressure or heart rate more than or equal to 20%of the baseline value within 3 min after placement of the laryngeal mask airway or as the occurrence of body movement,bucking,frowning,mouth and face twitching,tearing,laryngospasm or the BIS value failing to drop below 60.The study was performed by the Dixon′s up-and-down method.The initial dose of ciprofol was 0.4 mg/kg,and the ratio between the two successive doses was 1.1.If a positive response occurred,the dose was increased in the next patient,otherwise the dose was reduced.The ED50 and 95%confidence interval of ciprofol inhibiting responses to insertion of laryngeal mask airway were calculated by the probit method.Results The ED50(95%confidence interval)of ciprofol inhibiting responses to insertion of laryngeal mask airway was 0.291(0.231-0.318)mg/kg when combined with alfentanil 10μg/kg.Conclusions The ED50 of ciprofol inhibiting responses to insertion of laryngeal mask airway is 0.291 mg/kg in the patients when combined with alfentanil 10μg/kg.