中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2013年
1期
46-48
,共3页
麻伟青%张承华%杨云丽%奚曦%刘洁
痳偉青%張承華%楊雲麗%奚晞%劉潔
마위청%장승화%양운려%해희%류길
舒芬太尼%药物释放系统%剂量效应关系,药物
舒芬太尼%藥物釋放繫統%劑量效應關繫,藥物
서분태니%약물석방계통%제량효응관계,약물
Sufentanil%Drug delivery systems%Dose-response relationship,drug
目的 确定脊柱侧弯矫形术患者术中唤醒试验成功时舒芬太尼的半数有效效应室靶浓度(EC50).方法 拟在七氟醚-舒芬太尼复合麻醉下行脊柱侧弯矫形术患者90例,年龄18～64岁,BMI＜30 kg/m2,ASA分级Ⅰ或Ⅱ级.采用分层随机法将患者分为6组(n=15):Ⅰ组～Ⅵ组.各组均采用舒芬太尼、依托咪酯和顺阿曲库铵麻醉诱导,气管插管后机械通气,采用七氟醚、舒芬太尼和顺阿曲库铵维持麻醉.唤醒试验前停止输注顺阿曲库铵,下调七氟醚呼气末靶浓度至0,设定Ⅰ组唤醒试验时舒芬太尼Ce0.19 ng/ml,Ⅱ组Ce 0.18 ng/ml,相邻两组Ce梯度为0.01 ng/ml,每组依次递减.5 min后开始唤醒.采用半数有效剂量试验设计寇氏法,计算舒芬太尼的EC50及其95％可信区间.结果 脊柱侧弯矫形术患者术中唤醒试验成功时舒芬太尼的EC50为0.164 ng/ml,其95％CI为0.157～ 0.172ng/ml.结论 脊柱侧弯矫形术患者术中唤醒试验成功时舒芬太尼的EC50为0.164 ng/ml.
目的 確定脊柱側彎矯形術患者術中喚醒試驗成功時舒芬太尼的半數有效效應室靶濃度(EC50).方法 擬在七氟醚-舒芬太尼複閤痳醉下行脊柱側彎矯形術患者90例,年齡18～64歲,BMI＜30 kg/m2,ASA分級Ⅰ或Ⅱ級.採用分層隨機法將患者分為6組(n=15):Ⅰ組～Ⅵ組.各組均採用舒芬太尼、依託咪酯和順阿麯庫銨痳醉誘導,氣管插管後機械通氣,採用七氟醚、舒芬太尼和順阿麯庫銨維持痳醉.喚醒試驗前停止輸註順阿麯庫銨,下調七氟醚呼氣末靶濃度至0,設定Ⅰ組喚醒試驗時舒芬太尼Ce0.19 ng/ml,Ⅱ組Ce 0.18 ng/ml,相鄰兩組Ce梯度為0.01 ng/ml,每組依次遞減.5 min後開始喚醒.採用半數有效劑量試驗設計寇氏法,計算舒芬太尼的EC50及其95％可信區間.結果 脊柱側彎矯形術患者術中喚醒試驗成功時舒芬太尼的EC50為0.164 ng/ml,其95％CI為0.157～ 0.172ng/ml.結論 脊柱側彎矯形術患者術中喚醒試驗成功時舒芬太尼的EC50為0.164 ng/ml.
목적 학정척주측만교형술환자술중환성시험성공시서분태니적반수유효효응실파농도(EC50).방법 의재칠불미-서분태니복합마취하행척주측만교형술환자90례,년령18～64세,BMI＜30 kg/m2,ASA분급Ⅰ혹Ⅱ급.채용분층수궤법장환자분위6조(n=15):Ⅰ조～Ⅵ조.각조균채용서분태니、의탁미지화순아곡고안마취유도,기관삽관후궤계통기,채용칠불미、서분태니화순아곡고안유지마취.환성시험전정지수주순아곡고안,하조칠불미호기말파농도지0,설정Ⅰ조환성시험시서분태니Ce0.19 ng/ml,Ⅱ조Ce 0.18 ng/ml,상린량조Ce제도위0.01 ng/ml,매조의차체감.5 min후개시환성.채용반수유효제량시험설계구씨법,계산서분태니적EC50급기95％가신구간.결과 척주측만교형술환자술중환성시험성공시서분태니적EC50위0.164 ng/ml,기95％CI위0.157～ 0.172ng/ml.결론 척주측만교형술환자술중환성시험성공시서분태니적EC50위0.164 ng/ml.
Objective To determine the median effective target effect-site concentration (EC50) of sufentanil when intraoperative wake-up test was successful in patients undergoing scoliosis surgery.Methods Ninety ASA Ⅰ or Ⅱ patients,aged 18-64 yr,with body mass index ＜ 30 kg/m2,scheduled for scoliosis surgery under sevoflurane and sufentanil anesthesia,were randomly divided into Ⅰ-Ⅵ groups (n =15 each).Anesthesia was induced with sufentanil,etomidate and cisatracurium,and maintained with sevoflurane,sufentanil and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Before the wake-up test,infusion of cisatracurium was stopped and the end-tidal concentration of sevoflurane was adjusted to 0.The EC50 was determined by the K(a)rber method.The target effect-site concentration of sufentanil was set at 0.19 ng/ml in group Ⅰ,0.18 ng/ml in group Ⅱ and gradually decreased in decrements of 0.01 ng/ml.The wake-up test was performed 5 min later.The EC50 and 95 ％ confidence interval of sufentanil were calculated by the K(a)rber method.Results EC50 of sufentanil obtained was 0.164 ng/ml and 95％ confidence interval of sufentanil obtained was 0.157-0.172 ng/ml when the wake-up test was successful.Conclusion The EC50 of sufentanil is 0.164 ng/ml when the intraoperative wake-up test is successful in the patients undergoing scoliosis surgery.
