CAJ | 학술논문

目的确定新生儿七氟烷的最低肺泡有效浓度(MAC).方法择期全麻新生儿30例,正常体重,ASA分级Ⅰ或Ⅱ级.吸入6.00％七氟烷诱导气管插管,机械通气后调整吸入七氟烷浓度以达到呼气末浓度的预定值,维持20 min后开始切皮.根据改良序贯法进行试验,初始七氟烷呼气末浓度为3.00％,切皮时发生体动反应,下一例升高一个浓度梯度,切皮时未发生体动反应,下一例降低一个浓度梯度,相邻浓度梯度为0.25％.采用逻辑回归法计算新生儿七氟烷MAC和95％有效浓度及其95％可信区间.结果新生儿七氟烷MAC和95％有效浓度及其95％可信区间分别为2.82％(2.66％～ 2.98％)和3.39％(2.89％～3.89％).结论国内新生儿七氟烷MAC为2.82％,低于目前国外参考值.
목적 학정신생인칠불완적최저폐포유효농도(MAC).방법 택기전마신생인30례,정상체중,ASA분급Ⅰ혹Ⅱ급.흡입6.00％칠불완유도기관삽관,궤계통기후조정흡입칠불완농도이체도호기말농도적예정치,유지20 min후개시절피.근거개량서관법진행시험,초시칠불완호기말농도위3.00％,절피시발생체동반응,하일례승고일개농도제도,절피시미발생체동반응,하일례강저일개농도제도,상린농도제도위0.25％.채용라집회귀법계산신생인칠불완MAC화95％유효농도급기95％가신구간.결과 신생인칠불완MAC화95％유효농도급기95％가신구간분별위2.82％(2.66％～ 2.98％)화3.39％(2.89％～3.89％).결론 국내신생인칠불완MAC위2.82％,저우목전국외삼고치.
Objective To determine the minimum alveolar concentration (MAC) of sevoflurane in Chinese neonates.Methods Thirty ASA Ⅰ or Ⅱ neonates,aged ≤ 28 days,with normal body weight,scheduled for elective surgery under general anesthesia,were enrolled in the study.Anesthesia was induced with inhalation of 6.00％ sevoflurane in oxygen.The infants were tracheal intubated and mechanically ventilated.The inhaled concentration of sevoflurane was adjusted to achieve the preset end-tidal concentration and maintained at this level for 20 min.Skin incision was then performed.The concentration of sevoflurane was determined by modified Dixon's up-and-down method.The initial end-tidal concentration of sevofluren was 3.00％.Each time the concentration increased/decreased by 0.25 ％ in the next infant according to the infant's response.Successful skin incision was defined as no body movement during skin incision.The MAC,ED95 and 95 ％ confidence interval of sevoflurane were calculated using logistic regression analysis.Results The MAC and ED95 (95 ％ confidence interval) of sevoflurane required for successful skin incision were 2.82％ (2.66％-2.98％) and 3.39％ (2.89％-3.89％),respectively,in neonates.Conclusion The MAC of sevoflurane is 2.82 ％ in Chinese neonates and lower than the present reference values previously described in foreign reports.