中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2011年
5期
536-538
,共3页
刘英志%马志爽%刘勇波%王世端%徐成
劉英誌%馬誌爽%劉勇波%王世耑%徐成
류영지%마지상%류용파%왕세단%서성
右美托咪啶%舒芬太尼%药物释放系统%剂量效应关系,药物%甲状腺切除术
右美託咪啶%舒芬太尼%藥物釋放繫統%劑量效應關繫,藥物%甲狀腺切除術
우미탁미정%서분태니%약물석방계통%제량효응관계,약물%갑상선절제술
Dexmedetomidine%Sufentanil%Drug delivery systems%Dose-response relationship,drug%Thyroidectomy
目的 评价右美托咪啶对舒芬太尼抑制甲状腺切除术患者体动反应的半数有效效应室靶浓度(EC50)的影响.方法 择期行甲状腺双叶次全切除术患者,性别不限,ASA分级Ⅰ或Ⅱ级,年龄20～64岁,体重指数20～2.5 kg/m2,采用随机数字表法,将其随机分为2组,D组经10 min静脉输注右美托咪啶0.6 μg/kg,C组给予等容量生理盐水,停止给药后5 min时开始靶控输注异丙酚,血浆靶浓度为3.0 μg/ml,输注10 min时,2组开始靶控输注舒芬太尼,第1例患者的效应室靶浓度为0.20ng/ml,输注舒芬太尼3 min时置入喉罩,保留自主呼吸,待舒芬太尼达到目标靶浓度后,开始手术.根据切皮时是否发生体动反应确定下一例患者舒芬太尼的靶浓度,相邻靶浓度比值为1.2.采用序贯法计算舒芬太尼抑制切皮时体动反应的EC50及其95%可信区间(95%CI).结果 C组和D组样本数分别为19和20,舒芬太尼抑制切皮时体动反应的EC50分别为0.1454 ng/ml(95%CI 0.1339～0.1580 ng/ml)和0.1148 ng/ml(95%CI 0.1055～0.1249 ng/ml),D组EC50低于C组(P＜0.05).结论 术前静脉注射右美托咪啶0.6 μg/kg可降低舒芬太尼抑制甲状腺切除术患者切皮时体动反应的EC50.
目的 評價右美託咪啶對舒芬太尼抑製甲狀腺切除術患者體動反應的半數有效效應室靶濃度(EC50)的影響.方法 擇期行甲狀腺雙葉次全切除術患者,性彆不限,ASA分級Ⅰ或Ⅱ級,年齡20～64歲,體重指數20～2.5 kg/m2,採用隨機數字錶法,將其隨機分為2組,D組經10 min靜脈輸註右美託咪啶0.6 μg/kg,C組給予等容量生理鹽水,停止給藥後5 min時開始靶控輸註異丙酚,血漿靶濃度為3.0 μg/ml,輸註10 min時,2組開始靶控輸註舒芬太尼,第1例患者的效應室靶濃度為0.20ng/ml,輸註舒芬太尼3 min時置入喉罩,保留自主呼吸,待舒芬太尼達到目標靶濃度後,開始手術.根據切皮時是否髮生體動反應確定下一例患者舒芬太尼的靶濃度,相鄰靶濃度比值為1.2.採用序貫法計算舒芬太尼抑製切皮時體動反應的EC50及其95%可信區間(95%CI).結果 C組和D組樣本數分彆為19和20,舒芬太尼抑製切皮時體動反應的EC50分彆為0.1454 ng/ml(95%CI 0.1339～0.1580 ng/ml)和0.1148 ng/ml(95%CI 0.1055～0.1249 ng/ml),D組EC50低于C組(P＜0.05).結論 術前靜脈註射右美託咪啶0.6 μg/kg可降低舒芬太尼抑製甲狀腺切除術患者切皮時體動反應的EC50.
목적 평개우미탁미정대서분태니억제갑상선절제술환자체동반응적반수유효효응실파농도(EC50)적영향.방법 택기행갑상선쌍협차전절제술환자,성별불한,ASA분급Ⅰ혹Ⅱ급,년령20～64세,체중지수20～2.5 kg/m2,채용수궤수자표법,장기수궤분위2조,D조경10 min정맥수주우미탁미정0.6 μg/kg,C조급여등용량생리염수,정지급약후5 min시개시파공수주이병분,혈장파농도위3.0 μg/ml,수주10 min시,2조개시파공수주서분태니,제1례환자적효응실파농도위0.20ng/ml,수주서분태니3 min시치입후조,보류자주호흡,대서분태니체도목표파농도후,개시수술.근거절피시시부발생체동반응학정하일례환자서분태니적파농도,상린파농도비치위1.2.채용서관법계산서분태니억제절피시체동반응적EC50급기95%가신구간(95%CI).결과 C조화D조양본수분별위19화20,서분태니억제절피시체동반응적EC50분별위0.1454 ng/ml(95%CI 0.1339～0.1580 ng/ml)화0.1148 ng/ml(95%CI 0.1055～0.1249 ng/ml),D조EC50저우C조(P＜0.05).결론 술전정맥주사우미탁미정0.6 μg/kg가강저서분태니억제갑상선절제술환자절피시체동반응적EC50.
Objective To investigate the effect of dexmedetomidine on median effective target effect-site concentration ( EC50) of sufentanil inhibiting body movement evoked by skin incision in patients undergoing bilateral subtotal thyroidectomy. Methods Thirty-nine ASA I or II patients of both sexes aged 20-64 yr with a body mass index of 20-25 kg/m2 undergoing bilateral subtotal thyroidectomy were randomly divided into 2 groups: control group (group C) and dexmedetomidine group (group D). The patients were premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. In group D dexmedetomidine 0.6 μg/kg was injected iv over 10 min at S min before induction of anesthesia. Anesthesia was induced with target-controlled infusion (TCI) of propofol and sufentanil. The target plasma concentration of propofol was set at 3.0 μg/ml which was maintained until the end of operation. TCI of sufentanil was started at 10 min after initiation of propofol TCI. The initial target effect-site concentration was set at 0.20 ng/ml and decreased/increased by 20% in the next patient according to whether the patient's body moved or not within 1 min after skin incision. Laryngeal mask airway was inserted at 3 min after initiation of sufentanil TCI. Spontaneous breathing was maintained. Skin incision was made at 10 min after initiation of sufentanil TCI. The EC50 and 95% confidence interval (CI) of sufentanil inhibiting skin incision-evoked body movement were calculated with sequential method. Results EC50, of sufentanil was 0.1148 ng/ml (95% CI 0.1055-0.1249 ng/ml) in group D and 0.1454 ng/ml (95% CI 0.1339-0.1580 ng/ml) in group C, and was significantly lower in group D than in group C. Conclusion Dexmedetomidine 0.6 μg/kg infused iv before operation can reduce the EC50 of sufentanil inhibiting body movement evoked by skin incision in patients undergoing bilateral subtotal thyroidectomy.
