CAJ | 학술논문

目的探讨复合TCI异丙酚时瑞芬太尼抑制支撑喉镜诱发心血管反应的半数有效血浆靶浓度(EC50).方法择期拟行全麻下声带息肉摘除术患者20例,ASAⅠ或Ⅱ级,年龄20～51岁,体重52～83 kg,TCI瑞芬太尼和异丙酚行麻醉诱导,异丙酚血浆靶浓度4μg/ml,瑞芬太尼血浆靶浓度采用序贯法确定,第1例患者瑞芬太尼的血浆靶浓度5ng/ml,相邻靶浓度之比为1.2,以HR或MAP变化幅度超过基础状态15%为心血管反应阳性的判断标准.气管插管后3 min置人支撑喉镜.计算瑞芬太尼抑制支撑喉镜诱发心血管反应的EC50及其95%可信区间(CI).结果所有患者均未见胸壁僵硬,均未发生术中知晓.瑞芬太尼抑制支撑喉镜诱发心血管反应的EC50为3.50 ng/ml,95%CI为3.47～3.60 ng/ml.结论复合TCI异丙酚4μg/ml时瑞芬太尼抑制支撑喉镜诱发心血管反应的EC50为3.50 ng/ml,95%CI为3.47～3.60 ng/ml.
목적 탐토복합TCI이병분시서분태니억제지탱후경유발심혈관반응적반수유효혈장파농도(EC50).방법 택기의행전마하성대식육적제술환자20례,ASAⅠ혹Ⅱ급,년령20～51세,체중52～83 kg,TCI서분태니화이병분행마취유도,이병분혈장파농도4μg/ml,서분태니혈장파농도채용서관법학정,제1례환자서분태니적혈장파농도5ng/ml,상린파농도지비위1.2,이HR혹MAP변화폭도초과기출상태15%위심혈관반응양성적판단표준.기관삽관후3 min치인지탱후경.계산서분태니억제지탱후경유발심혈관반응적EC50급기95%가신구간(CI).결과 소유환자균미견흉벽강경,균미발생술중지효.서분태니억제지탱후경유발심혈관반응적EC50위3.50 ng/ml,95%CI위3.47～3.60 ng/ml.결론 복합TCI이병분4μg/ml시서분태니억제지탱후경유발심혈관반응적EC50위3.50 ng/ml,95%CI위3.47～3.60 ng/ml.
Objective To determine the median effective concentration(EC50) of remifentanil by TCI inhibiting the cardiovascular response to the placement of operating laryngoscope performed under propofol anesthesia administered by TCI.Methods Twenty ASA Ⅰ orⅡ patients,aged 20-51 yr,weighing 52-83 kg,undergoing extirpation of vocal cord polyps under general anesthesia with remifentanil-pmpofol administered by TCI.were enrolled in the study.The target plasma concentration (Cp) of propofol was set at 4μg/ml.Operating laryngoscope was placed at 3 min after tracheal intubation.HR and MAP were continuously monitored.When HR or MAP increased by 15%,the candiovascular response was defined as positive.The EC50 was determined by up-and-down technique.The initial Cp of remifentanil was set at 5 ng/ml and was increased/decreased by 20%in the next patient if the cardiovascular response was positive or negative.Results No chest wall stiffness and intraoperative awareness occurred in all the patients.The EC50 of remifentanil TCI inhibiting the cardiovascular response to the placement of operating laryngoscope was 3.50ng/ml with confidence interval(CI) between 3.47-3.60 ng/ml.Conclusion Thee EC50 of remifentanil TCI inhibiting cardiovascular response to the placement of operating laryngoscope is 3.50ng/ml with CI between 3.47-3.60ng/ml.