CAJ | 학술논문

目的确定复合异丙酚时舒芬太尼抑制置入输尿管镜时病人体动反应的半数有效效应室靶浓度(EC50).方法择期行经尿道输尿管镜钬激光碎石术病人50例,性别不限,年龄20～60岁,BMI＜30 kg/m2,ASA分级Ⅰ级或Ⅱ级,随机分为不同舒芬太尼效应室靶浓度组(n=10),S1组、S2组、S3组、S4组和S5组舒芬太尼效应室靶浓度分别0.21、0.14、0.09、0.06、0.04 ng/ml.靶控输注异丙酚,血浆靶浓度2.5～3.0μg/ml,各组按相应效应室靶浓度靶控输注舒芬太尼,待病人意识消失且舒芬太尼达效应室浓度时置入输尿管镜,以进镜即刻至进镜后1 min内病人发生体动反应(咳嗽和吞咽动作除外)为阳性反应.采用Bliss法计算复合异丙酚时舒芬太尼抑制置入输尿管镜时病人体动反应的EC50为及其95%可信区间.结果复合异丙酚时舒芬太尼抑制置入输尿管镜时病人体动反应的EC50为0.084 ng/ml,95%可信区间为0.066～0.107 ng/ml.结论复合异丙酚时,舒芬太尼抑制置入输尿管镜时病人体动反应的EC50为0.084 ng/ml.
목적 학정복합이병분시서분태니억제치입수뇨관경시병인체동반응적반수유효효응실파농도(EC50).방법 택기행경뇨도수뇨관경화격광쇄석술병인50례,성별불한,년령20～60세,BMI＜30 kg/m2,ASA분급Ⅰ급혹Ⅱ급,수궤분위불동서분태니효응실파농도조(n=10),S1조、S2조、S3조、S4조화S5조서분태니효응실파농도분별0.21、0.14、0.09、0.06、0.04 ng/ml.파공수주이병분,혈장파농도2.5～3.0μg/ml,각조안상응효응실파농도파공수주서분태니,대병인의식소실차서분태니체효응실농도시치입수뇨관경,이진경즉각지진경후1 min내병인발생체동반응(해수화탄인동작제외)위양성반응.채용Bliss법계산복합이병분시서분태니억제치입수뇨관경시병인체동반응적EC50위급기95%가신구간.결과 복합이병분시서분태니억제치입수뇨관경시병인체동반응적EC50위0.084 ng/ml,95%가신구간위0.066～0.107 ng/ml.결론복합이병분시,서분태니억제치입수뇨관경시병인체동반응적EC50위0.084 ng/ml.
Objective To determine the half-effective target effect-site concentration (Ce) (EC50) of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol in patients undergoing transureteroscopic holmium laser lithotripsy. Methods Fifty ASA Ⅰ or Ⅱ patients of both sexes, aged 20-60 yr, BMI ＜ 30 kg/m2 , undergoing transureteroscopic holmium laser lithotripsy were randomly divided into 5 groups according to the different C es of sufentanil ( n = 10 each): group S1 (Ce 0.21 ng/ml), group S2(Ce 0.14 ng/ml), group S3(Ce 0.09 ng/ml), group S4(Ce 0.06 ng/ml), group S5(Ce 0.04 ng/ml). TCI of propofol with target plasma concentration set at 2.5-3.0 μg/ml was given. Sufentanil with the corresponding Ce was infused in each group. The ureteroscopes were inserted as soon as the patients lost consciousness and the effect-site concentration of sunfentanil was achieved. The response was defined as positive when body movement occurred within 1 min after insertion of ureteroscopes. The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol and 95% confidence interval (CI) were calculated. Results The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol was 0.084 ng/ml and 95% CI was 0.066-0.107 ng/ml. Conclusion The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes was 0.084 ng/ml when combined with propofol.