CAJ | 학술논문

目的：测定不同剂量瑞芬太尼麻醉下丙泊酚抑制老年患者胃镜插入时体动的半数有效剂量（ED50）。方法选择2013年10月至2014年5月90例在南京鼓楼医院自愿接受无痛胃镜检查的90例老年患者为研究对象，按照静脉滴注瑞芬太尼的剂量随机分为三组，每组30例，A组0．15μg／kg、B组0．30μg／kg、C组0．45μg／kg，依次缓慢推注丙泊酚和瑞芬太尼，以胃镜插入时有无体动或呛咳为指标，采用序贯法测定各组丙泊酚抑制胃镜插入时体动的ED50和95％可信区间。结果A、B、C三组丙泊酚抑制胃镜插入时体动的ED50分别为0．80、0．69、0．57mg／kg，95％可信区间分别为（0．72～0．88）mg／kg、（0．60～0．78）mg／kg、（0．52～0．62）mg／kg。结论老年患者无痛胃镜麻醉诱导时，丙泊酚和瑞芬太尼呈协同作用，瑞芬太尼能减少丙泊酚抑制胃镜插入时体动的ED50。
목적：측정불동제량서분태니마취하병박분억제노년환자위경삽입시체동적반수유효제량（ED50）。방법선택2013년10월지2014년5월90례재남경고루의원자원접수무통위경검사적90례노년환자위연구대상，안조정맥적주서분태니적제량수궤분위삼조，매조30례，A조0．15μg／kg、B조0．30μg／kg、C조0．45μg／kg，의차완만추주병박분화서분태니，이위경삽입시유무체동혹창해위지표，채용서관법측정각조병박분억제위경삽입시체동적ED50화95％가신구간。결과A、B、C삼조병박분억제위경삽입시체동적ED50분별위0．80、0．69、0．57mg／kg，95％가신구간분별위（0．72～0．88）mg／kg、（0．60～0．78）mg／kg、（0．52～0．62）mg／kg。결론노년환자무통위경마취유도시，병박분화서분태니정협동작용，서분태니능감소병박분억제위경삽입시체동적ED50。
Objective To detection the median effective dose (ED50)of propofol under remifentanil intrave‐nous anesthesia for preventing body movement during gastroscope insertion of elderly patients .Methods Ninety eld‐erly patients undergoing painless gastroscopy were randomly divided into three groups ,each group with thirty cases .The remifentanil intravenous doses of the three groups were 0 .15μg /kg (group A)、0 .30 μg/kg (group B) and 0 .45 μg/kg (group C)respectively .The dose of propofol was adjusted according to the patient's reaction using an up‐and‐down method .Using sequential design ,the ED50 of propofol was determined .Results The ED50 of propofol were 0 .80 mg/kg[95% confidence interval(CI):0 .72-0 .88 mg/kg]in group A ,0 .69 mg /kg(95% CI:0 .60-0 .78 mg/kg)in group B ,0 .57 mg/kg (95% CI:0 .52 -0 .62 mg/kg )in group C .Conclusion For anesthesia induction of painless gastroscopy ,the pharmacodynamic interaction between remifentanil and propofol was synergism ,remifentanil could decrease the ED50 of propofol to prevent the body movement response to gastroscope insertion .