CAJ | 학술논문

目的确定瑞芬太尼抑制患儿臂丛神经阻滞穿刺诱发体动反应的半数有效血浆靶浓度(Cp50).方法择期前臂或手外科手术患儿,年龄5～12岁,性别不限,发育正常,麻醉前30 min口服咪达唑仑0.2 mg/kg.瑞芬太尼初始血浆靶浓度5.0 ng/ml,采用序贯法确定其血浆靶浓度,穿刺诱发体动反应时下一例上调1级浓度,否则下调1级浓度,相邻浓度比值1.2.血浆靶浓度和效应室浓度达到平衡时,行臂丛神经阻滞穿刺.体动反应判断标准:穿刺诱发的肢体或/和头颈部的运动反应.计算其Cp50及95％可信区间.结果瑞芬太尼抑制臂丛神经阻滞穿刺诱发体动反应的Cp50为3.9ng/ml,其95％可信区间为3.6～ 4.2 ng/ml.结论瑞芬太尼抑制患儿臂丛神经阻滞穿刺诱发体动反应的Cp50为3.9 ng/ml.
목적 학정서분태니억제환인비총신경조체천자유발체동반응적반수유효혈장파농도(Cp50).방법 택기전비혹수외과수술환인,년령5～12세,성별불한,발육정상,마취전30 min구복미체서륜0.2 mg/kg.서분태니초시혈장파농도5.0 ng/ml,채용서관법학정기혈장파농도,천자유발체동반응시하일례상조1급농도,부칙하조1급농도,상린농도비치1.2.혈장파농도화효응실농도체도평형시,행비총신경조체천자.체동반응판단표준:천자유발적지체혹/화두경부적운동반응.계산기Cp50급95％가신구간.결과 서분태니억제비총신경조체천자유발체동반응적Cp50위3.9ng/ml,기95％가신구간위3.6～ 4.2 ng/ml.결론 서분태니억제환인비총신경조체천자유발체동반응적Cp50위3.9 ng/ml.
Objective To determine the median effective target plasma concentration (Cp50) of remifentainil inhibiting body movement evoked by puncture during brachial plexus block in pediatric patients.Methods Pediatric patients of both sexes,aged 5-12 yr,who grown normally,scheduled for elective forearm or hand surgery,were enrolled in this study.Children were premedicated with oral midazolam 0.2 mg/kg at 30 min before anesthesia.The initial target Cp of remifentainil was 5.0 ng/ml.The target Cp was determined by up-and-down sequential method.Each time Cp increased/decreased by 20％ in the next patient depending on the response of the previous patient to puncture.The ratio between the two successive concentrations was 1.2.The puncture was performed after the target effect-site and plasma concentrations were balanced.Body movement was defined as puncture-induced movement of truncus,limbs and/or head and neck.The Cp50 and 95 ％ confidence interval of remifentainil were calculated by Dixon method.Results Cp50 of remifentainil inhibiting body movement evoked by puncture during brachial plexus block was 3.9 ng/ml,and 95 ％ confidence interval was 3.6-4.2 ng/ml.Conclusion Cp50 of remifentainil inhibiting body movement evoked by puncture during brachial plexus block is 3.9 ng/ml in pediatric patients.