中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2009年
3期
207-209
,共3页
张倩%宋子贤%彭云水%贾丽%宗银东%王士杰%邢玉英
張倩%宋子賢%彭雲水%賈麗%宗銀東%王士傑%邢玉英
장천%송자현%팽운수%가려%종은동%왕사걸%형옥영
年龄因素%性别因素%二异丙酚%呼吸功能不全%药物释放系统%剂量效应关系,药物
年齡因素%性彆因素%二異丙酚%呼吸功能不全%藥物釋放繫統%劑量效應關繫,藥物
년령인소%성별인소%이이병분%호흡공능불전%약물석방계통%제량효응관계,약물
Age factors%Sex factors%Propofol%Respiratory insufficiency%Drug delivery systems%Dose-response relationship,drug
目的 评价年龄及性别对全麻患者靶控输注异丙酚呼吸抑制时半数有效血浆靶浓度(EC50)的影响.方法 择期全麻手术患者80例,ASA Ⅰ或Ⅱ级,年龄40～79岁,分为中年男性组(MA组,n=20)、中年女性组(FA组,n=20)、老年男性组(MO组,n=20)和老年女性组(Fo组,n=20).按序贯法采用Marsh药代动力学参数靶控输注异丙酚,第1例患者血浆靶浓度设为3.1 t,μg/ml,相邻靶浓度比值为1.1.出现呼吸抑制为阳性反应,靶控输注15 min仍未出现呼吸抑制则为阴性反应.计算异丙酚呼吸抑制的EC50及其95%可信区间.结果 靶控输注异丙酚呼吸抑制的EC50及其95%可信区间分别为:MA组6.40(6.09-6.72)μg/ml,FA组5.93(5.54-6.34)μg/ml,MO组4.58(4.32～4.91)μg/ml,FO组4.37(4.14-4.61)μg/ml.与FA组比较,FO组EC50降低(P<0.05),MA组EC50差异无统计学意义(P>0.05);与MA组比较.M0组EC50降低(P<0.05);MO组与FO组EC50差异无统计学意义(P>0.05).结论 靶控输注异丙酚对老年患者呼吸抑制的效力高于中年患者,而性别对其无影响.
目的 評價年齡及性彆對全痳患者靶控輸註異丙酚呼吸抑製時半數有效血漿靶濃度(EC50)的影響.方法 擇期全痳手術患者80例,ASA Ⅰ或Ⅱ級,年齡40～79歲,分為中年男性組(MA組,n=20)、中年女性組(FA組,n=20)、老年男性組(MO組,n=20)和老年女性組(Fo組,n=20).按序貫法採用Marsh藥代動力學參數靶控輸註異丙酚,第1例患者血漿靶濃度設為3.1 t,μg/ml,相鄰靶濃度比值為1.1.齣現呼吸抑製為暘性反應,靶控輸註15 min仍未齣現呼吸抑製則為陰性反應.計算異丙酚呼吸抑製的EC50及其95%可信區間.結果 靶控輸註異丙酚呼吸抑製的EC50及其95%可信區間分彆為:MA組6.40(6.09-6.72)μg/ml,FA組5.93(5.54-6.34)μg/ml,MO組4.58(4.32～4.91)μg/ml,FO組4.37(4.14-4.61)μg/ml.與FA組比較,FO組EC50降低(P<0.05),MA組EC50差異無統計學意義(P>0.05);與MA組比較.M0組EC50降低(P<0.05);MO組與FO組EC50差異無統計學意義(P>0.05).結論 靶控輸註異丙酚對老年患者呼吸抑製的效力高于中年患者,而性彆對其無影響.
목적 평개년령급성별대전마환자파공수주이병분호흡억제시반수유효혈장파농도(EC50)적영향.방법 택기전마수술환자80례,ASA Ⅰ혹Ⅱ급,년령40～79세,분위중년남성조(MA조,n=20)、중년녀성조(FA조,n=20)、노년남성조(MO조,n=20)화노년녀성조(Fo조,n=20).안서관법채용Marsh약대동역학삼수파공수주이병분,제1례환자혈장파농도설위3.1 t,μg/ml,상린파농도비치위1.1.출현호흡억제위양성반응,파공수주15 min잉미출현호흡억제칙위음성반응.계산이병분호흡억제적EC50급기95%가신구간.결과 파공수주이병분호흡억제적EC50급기95%가신구간분별위:MA조6.40(6.09-6.72)μg/ml,FA조5.93(5.54-6.34)μg/ml,MO조4.58(4.32～4.91)μg/ml,FO조4.37(4.14-4.61)μg/ml.여FA조비교,FO조EC50강저(P<0.05),MA조EC50차이무통계학의의(P>0.05);여MA조비교.M0조EC50강저(P<0.05);MO조여FO조EC50차이무통계학의의(P>0.05).결론 파공수주이병분대노년환자호흡억제적효력고우중년환자,이성별대기무영향.
Objective To evaluate the effects of gender and age on median-effective target plasma concentration(EC50)of propofol administered by target controlled infusion(TCI)causing respiratory depression.Methods Eighty ASA Ⅰ or Ⅱ patients aged 40-79 yr,with body mass index 18-25 kg/m2.undergoing general anesthesia were divided into 4 groups(n=20 each):1 middle-aged male group(MA);Ⅱ middle-aged female group(FA);Ⅲold male group(MO) and Ⅳo ld female group(FO).No premedication was administered.Propofol Was administered by TCI for 15 min,using TCI system incorporating Marsh pharmacokinetic model.EC50 Was determined by up-end-down sequential trial.The target plasma concentration(Cr)was set at 3.1μg/ml in the first Patient in each group.Each time Cr increased/decreased by 10%in the next patient depending on whether or not the respiratory depression occurred.Respiratory depression was defined as RR<8 bpm,Vr≤5 ml/kg,end-tidal PCO2≥50 mm Hg,SaO2≤94%and/or apnea≥15s.Results The EC50 and 95%confidence interval of propofol TCI causing respiratory depression were 6.40(6.09-6.72)μg/ml in group MA,5.93(5.54-6.34)μg/ml group FA,4.58(4.32-4.91)μg/ml in group MO and 4.37(4.14-4.61)μg/ml in group FO.EC50 was significantly lower in group FO than in group FA and in group MO than in group MA,but there Was no significant difference in EC50 between group MA and group FA or between group MO and FO. Conclusion The potency of propofol given by TCI causing respiratory depression is increased in the old patients as compared with the middle-aged patients and is not related to sex.
