中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2012年
2期
145-147
,共3页
周志飞%邬子林%佘守章%许立新%吕婧
週誌飛%鄔子林%佘守章%許立新%呂婧
주지비%오자림%사수장%허립신%려청
右美托咪啶%药物释放系统%意识丧失%剂量效应关系,药物
右美託咪啶%藥物釋放繫統%意識喪失%劑量效應關繫,藥物
우미탁미정%약물석방계통%의식상실%제량효응관계,약물
Dexmedetomidine%Drug delivery systems%Unconsciousness%Dose-response relationship,drug
目的 评价年龄因素对右美托咪啶靶控输注患者意识消失量效关系的影响.方法 脊椎-硬膜外麻醉下择期拟行下腹部或下肢手术患者60例,ASA分级Ⅰ或Ⅱ级,按照年龄分为中青年组(Y组,18 ～ 55岁)和老年组(O组,65～85岁),每组30例,每组按右美托咪啶靶浓度,采用随机数字表法将患者随机分为5个亚组,每组6例.Y1～5组右美托咪啶血浆靶浓度分别为0.54、0.64、0.76、0.90、1.07 ng/ml;O1-5右美托咪啶血浆靶浓度分别为0.36、0.42、0.51、0.60、0.71 ng/ml,以警觉/镇静评分≤2分和睫毛反射消失作为意识消失标准.记录30 min内每组患者意识消失的例数及其对应靶浓度,采用概率单位法计算两组意识消失的半数有效浓度( EC50)和95％有效浓度(EC95)及其95％可信区间(95％CI).结果 O组右美托咪啶使患者意识消失的EC50及其95％CI为0.478(0.424～0.536) ng/ml,EC95及其95％CI为0.641(0.567 ～ 0.816)ng/ml,Y组右美托咪啶使患者意识消失的EC50及其95％CI为0.738(0.657 ～ 0.827) ng/ml,EC95及其95％CI为0.990(0.874～ 1.267) ng/ml,差异均有统计学意义(P＜0.05).结论 靶控输注右美托咪啶老年患者意识消失的EC50和EC95均低于中青年患者,老年患者对右美托咪啶的镇静效应更敏感.
目的 評價年齡因素對右美託咪啶靶控輸註患者意識消失量效關繫的影響.方法 脊椎-硬膜外痳醉下擇期擬行下腹部或下肢手術患者60例,ASA分級Ⅰ或Ⅱ級,按照年齡分為中青年組(Y組,18 ～ 55歲)和老年組(O組,65～85歲),每組30例,每組按右美託咪啶靶濃度,採用隨機數字錶法將患者隨機分為5箇亞組,每組6例.Y1～5組右美託咪啶血漿靶濃度分彆為0.54、0.64、0.76、0.90、1.07 ng/ml;O1-5右美託咪啶血漿靶濃度分彆為0.36、0.42、0.51、0.60、0.71 ng/ml,以警覺/鎮靜評分≤2分和睫毛反射消失作為意識消失標準.記錄30 min內每組患者意識消失的例數及其對應靶濃度,採用概率單位法計算兩組意識消失的半數有效濃度( EC50)和95％有效濃度(EC95)及其95％可信區間(95％CI).結果 O組右美託咪啶使患者意識消失的EC50及其95％CI為0.478(0.424～0.536) ng/ml,EC95及其95％CI為0.641(0.567 ～ 0.816)ng/ml,Y組右美託咪啶使患者意識消失的EC50及其95％CI為0.738(0.657 ～ 0.827) ng/ml,EC95及其95％CI為0.990(0.874～ 1.267) ng/ml,差異均有統計學意義(P＜0.05).結論 靶控輸註右美託咪啶老年患者意識消失的EC50和EC95均低于中青年患者,老年患者對右美託咪啶的鎮靜效應更敏感.
목적 평개년령인소대우미탁미정파공수주환자의식소실량효관계적영향.방법 척추-경막외마취하택기의행하복부혹하지수술환자60례,ASA분급Ⅰ혹Ⅱ급,안조년령분위중청년조(Y조,18 ～ 55세)화노년조(O조,65～85세),매조30례,매조안우미탁미정파농도,채용수궤수자표법장환자수궤분위5개아조,매조6례.Y1～5조우미탁미정혈장파농도분별위0.54、0.64、0.76、0.90、1.07 ng/ml;O1-5우미탁미정혈장파농도분별위0.36、0.42、0.51、0.60、0.71 ng/ml,이경각/진정평분≤2분화첩모반사소실작위의식소실표준.기록30 min내매조환자의식소실적례수급기대응파농도,채용개솔단위법계산량조의식소실적반수유효농도( EC50)화95％유효농도(EC95)급기95％가신구간(95％CI).결과 O조우미탁미정사환자의식소실적EC50급기95％CI위0.478(0.424～0.536) ng/ml,EC95급기95％CI위0.641(0.567 ～ 0.816)ng/ml,Y조우미탁미정사환자의식소실적EC50급기95％CI위0.738(0.657 ～ 0.827) ng/ml,EC95급기95％CI위0.990(0.874～ 1.267) ng/ml,차이균유통계학의의(P＜0.05).결론 파공수주우미탁미정노년환자의식소실적EC50화EC95균저우중청년환자,노년환자대우미탁미정적진정효응경민감.
Objective To investigate the influence of age on hypnotic target plasma concentration (CT) of dexmedetomidine (Dex) administered by TCI.Methods Sixty ASA Ⅰ - Ⅱ patients aged 18-85 yr undergoing lower abdominal or extremity operation under combined spinal-epidural anesthesia were divided into 2 age groups ( n =30each):18 yr＜groupⅠ＜55 yr (Y) and 65 yr＜group Ⅱ＜85 yr (E).Each group was further divided into 5subgroups (n =6 each) receiving Dex administered by TCI at CT of 0.54,0.64,0.76,0.90,1.07 ng/ml in group Y and 0.36,0.42,0.51,0.60,0.71 ng/ml in group E respectively.Hypnosis was defined as no response to verbal command (OAA/S score ≤2) and loss of eyelash reflex.A quantal response model (probit analysis) was used to calculate the concentration-effect curve and predict plasma EC50 and EC95 (95％CI) of Dex.Results EC50 (95％CI) was 0.478(0.424-0.536) ng/ml and EC95(95％CI) 0.641 (0.567-0.816) ng/ml in group E,significantly lower than EC50 (95 ％ CI) 0.738 (0.657-0.827) ng/ml and EC95 (95％CI) 0.990 (0.874-1.267 ) ng/ml in group Y.Conclusion The EC50 and EC95 of dexmedetomidine for hypnosis were significantly lower in the elderly than in younger patients.
