国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2012年
5期
294-297
,共4页
贺文丽%秦再生%王辉%叶靖%徐建设
賀文麗%秦再生%王輝%葉靖%徐建設
하문려%진재생%왕휘%협정%서건설
丙泊酚%舒芬太尼%靶控输注%半数有效血浆浓度%气管插管%老年人
丙泊酚%舒芬太尼%靶控輸註%半數有效血漿濃度%氣管插管%老年人
병박분%서분태니%파공수주%반수유효혈장농도%기관삽관%노년인
Propofol%Sufentanil%Targeted-controlled infusion%The median effective plasma concentration%Tracheal intubation%The elderly
目的 探讨不同靶浓度的舒芬太尼复合丙泊酚靶控输注(targeted-controlled infusion,TCI)抑制气管插管反应的丙泊酚半数有效血浆浓度(the median effective plasma concentration,Cp50).方法 研究对象为94例择期全麻拟行气管插管手术患者,ASA Ⅰ～Ⅲ级,年龄在60岁～79岁.根据年龄段和舒芬太尼靶浓度的不同按随机数字表法分为4组,A组为60岁～69岁、0.2 μg/L;B组为60岁～69岁、0.3 μg/L;C组为70岁～79岁、0.2 μg/L;D组为70岁～79岁、0.3 μg/L.试验以效应室浓度TCI舒芬太尼,待舒芬太尼血浆浓度与效应室浓度平衡后,以血浆靶浓度TCI丙泊酚,意识消失后给予0.2 mg/kg的顺阿曲库铵,待丙泊酚的血浆浓度和效应室浓度平衡且静注顺阿曲库铵达3 min后行气管插管.丙泊酚的血浆靶浓度按序贯法确定.结果 A组患者有效抑制气管插管反应的丙泊酚的Cp50为3.60 mg/L,95％可信区间(confidence interval,CI)为3.44 mgl～3.76 mg/L;B组患者Cp50为2.03 mg/L,95％CI为1.88 mg/L～2.20 mg/L;C组患者Cp50为2.70 mg/L,95％CI为2.56 mg/L～2.84 mg/L;D组患者Cp50为1.97 mg/L,95％CI为1.81 mg/L～2.12 mg/L.结论 随着舒芬太尼的效应室靶浓度的增加以及年龄的增加,丙泊酚的Cp50明显降低.
目的 探討不同靶濃度的舒芬太尼複閤丙泊酚靶控輸註(targeted-controlled infusion,TCI)抑製氣管插管反應的丙泊酚半數有效血漿濃度(the median effective plasma concentration,Cp50).方法 研究對象為94例擇期全痳擬行氣管插管手術患者,ASA Ⅰ～Ⅲ級,年齡在60歲～79歲.根據年齡段和舒芬太尼靶濃度的不同按隨機數字錶法分為4組,A組為60歲～69歲、0.2 μg/L;B組為60歲～69歲、0.3 μg/L;C組為70歲～79歲、0.2 μg/L;D組為70歲～79歲、0.3 μg/L.試驗以效應室濃度TCI舒芬太尼,待舒芬太尼血漿濃度與效應室濃度平衡後,以血漿靶濃度TCI丙泊酚,意識消失後給予0.2 mg/kg的順阿麯庫銨,待丙泊酚的血漿濃度和效應室濃度平衡且靜註順阿麯庫銨達3 min後行氣管插管.丙泊酚的血漿靶濃度按序貫法確定.結果 A組患者有效抑製氣管插管反應的丙泊酚的Cp50為3.60 mg/L,95％可信區間(confidence interval,CI)為3.44 mgl～3.76 mg/L;B組患者Cp50為2.03 mg/L,95％CI為1.88 mg/L～2.20 mg/L;C組患者Cp50為2.70 mg/L,95％CI為2.56 mg/L～2.84 mg/L;D組患者Cp50為1.97 mg/L,95％CI為1.81 mg/L～2.12 mg/L.結論 隨著舒芬太尼的效應室靶濃度的增加以及年齡的增加,丙泊酚的Cp50明顯降低.
목적 탐토불동파농도적서분태니복합병박분파공수주(targeted-controlled infusion,TCI)억제기관삽관반응적병박분반수유효혈장농도(the median effective plasma concentration,Cp50).방법 연구대상위94례택기전마의행기관삽관수술환자,ASA Ⅰ～Ⅲ급,년령재60세～79세.근거년령단화서분태니파농도적불동안수궤수자표법분위4조,A조위60세～69세、0.2 μg/L;B조위60세～69세、0.3 μg/L;C조위70세～79세、0.2 μg/L;D조위70세～79세、0.3 μg/L.시험이효응실농도TCI서분태니,대서분태니혈장농도여효응실농도평형후,이혈장파농도TCI병박분,의식소실후급여0.2 mg/kg적순아곡고안,대병박분적혈장농도화효응실농도평형차정주순아곡고안체3 min후행기관삽관.병박분적혈장파농도안서관법학정.결과 A조환자유효억제기관삽관반응적병박분적Cp50위3.60 mg/L,95％가신구간(confidence interval,CI)위3.44 mgl～3.76 mg/L;B조환자Cp50위2.03 mg/L,95％CI위1.88 mg/L～2.20 mg/L;C조환자Cp50위2.70 mg/L,95％CI위2.56 mg/L～2.84 mg/L;D조환자Cp50위1.97 mg/L,95％CI위1.81 mg/L～2.12 mg/L.결론 수착서분태니적효응실파농도적증가이급년령적증가,병박분적Cp50명현강저.
Objective To investigate the median effective plasma concentration (Cp50) of propofol blunting cardiovascular responses to tracheal intubation with sufentanil at different targeted concentrations on anesthesia induction in elderly patients.Methods Ninty-four patients (60 years-79 years) with an American Society of ASA physical status of Ⅰ -Ⅲ,undergoing scheduled surgery under general anesthesia were randomly allocated into one of the four groups:group A,B,C and D.The patients in group A and group B (60 years-69 years) and the ones in group C and group D(70 years-79 years) received sufentanil with a target effect concentration of 0.2 μg/L,0.3 μg/L respectively.Induction of anesthesia was initiated by targeted-controlled infusion (TCI) of sufentanil at target effect-site concentration and was maintained stable before administration of propofol,determined by up and down sequential test.At the moment of loss of consciousness,cisatracurium 0.2 mg/kg was administered and intubated after 3 min.Results The Cp50 of propofol were 3.60,2.03,2.70,1.97 mg/L with 95％ confidence interval of 3.44 mg/L-3.76 mg /L,1.88 mg/L-2.20 mg/L,2.56 mg/L-2.84 mg/L and 1.81 mg/L-2.12 mg/L in group A,B,C and D respectively. Conclusions With the concentrations of sufentanil or increased age,the Cp50 of propofol decreases in elderly patients.
