中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2013年
12期
1431-1433
,共3页
万朝权%刘红%梅莉%张雪丰
萬朝權%劉紅%梅莉%張雪豐
만조권%류홍%매리%장설봉
喷他佐辛%二异丙酚%胃镜检查%剂量效应关系,药物%老年人
噴他佐辛%二異丙酚%胃鏡檢查%劑量效應關繫,藥物%老年人
분타좌신%이이병분%위경검사%제량효응관계,약물%노년인
Pentazocine%Propofol%Gastroscopy%Dose-response relationship,drug%Aged
目的 确定喷他佐辛复合异丙酚用于老年患者胃镜检查术时的适宜剂量.方法 择期全麻下行胃镜检查术老年患者140例,年龄65～75岁,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为Ⅰ组-Ⅳ组,每组35例.置入胃镜前Ⅱ组-Ⅳ组分别静脉注射喷他佐辛0.2、0.4和0.8 mg/kg,Ⅰ组给予等容量生理盐水,随后靶控输注异丙酚,初始血浆靶浓度设为3.5μg/nl,采用序贯法进行试验,待效应室浓度与血浆浓度达平衡后5 min时行胃镜检查术,如发生阳性发应,则下一例患者异丙酚升高1个浓度梯度,反之降低1个浓度梯度,浓度梯度为0.3μg/ml,发生阳性反应的标准为胃镜检查术过程中出现明显体动和/或呛咳.采用概率单位法计算靶控输注异丙酚抑制胃镜检查术反应的半数有效浓度(EC50)及其95％可信区间(95％ CI).记录呼吸抑制和低血压的发生情况.结果 Ⅰ组-Ⅳ组靶控输注异丙酚抑制胃镜检查术反应的EC50及其95％ CI分别为2.82(2.63～3.02) μg/ml、2.78(2.58～2.97)μg/ml、2.16(2.00～2.32)μg/ml和2.03(1.88 ～ 2.19) μg/ml.与Ⅰ组比较,Ⅲ组和Ⅳ组EC50降低,Ⅳ组呼吸抑制发生率升高(P＜0.05).结论 喷他佐辛复合异丙酚用于老年患者胃镜检查术时的适宜剂量为0.4 mg/kg.
目的 確定噴他佐辛複閤異丙酚用于老年患者胃鏡檢查術時的適宜劑量.方法 擇期全痳下行胃鏡檢查術老年患者140例,年齡65～75歲,ASA分級Ⅰ或Ⅱ級,採用隨機數字錶法分為Ⅰ組-Ⅳ組,每組35例.置入胃鏡前Ⅱ組-Ⅳ組分彆靜脈註射噴他佐辛0.2、0.4和0.8 mg/kg,Ⅰ組給予等容量生理鹽水,隨後靶控輸註異丙酚,初始血漿靶濃度設為3.5μg/nl,採用序貫法進行試驗,待效應室濃度與血漿濃度達平衡後5 min時行胃鏡檢查術,如髮生暘性髮應,則下一例患者異丙酚升高1箇濃度梯度,反之降低1箇濃度梯度,濃度梯度為0.3μg/ml,髮生暘性反應的標準為胃鏡檢查術過程中齣現明顯體動和/或嗆咳.採用概率單位法計算靶控輸註異丙酚抑製胃鏡檢查術反應的半數有效濃度(EC50)及其95％可信區間(95％ CI).記錄呼吸抑製和低血壓的髮生情況.結果 Ⅰ組-Ⅳ組靶控輸註異丙酚抑製胃鏡檢查術反應的EC50及其95％ CI分彆為2.82(2.63～3.02) μg/ml、2.78(2.58～2.97)μg/ml、2.16(2.00～2.32)μg/ml和2.03(1.88 ～ 2.19) μg/ml.與Ⅰ組比較,Ⅲ組和Ⅳ組EC50降低,Ⅳ組呼吸抑製髮生率升高(P＜0.05).結論 噴他佐辛複閤異丙酚用于老年患者胃鏡檢查術時的適宜劑量為0.4 mg/kg.
목적 학정분타좌신복합이병분용우노년환자위경검사술시적괄의제량.방법 택기전마하행위경검사술노년환자140례,년령65～75세,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법분위Ⅰ조-Ⅳ조,매조35례.치입위경전Ⅱ조-Ⅳ조분별정맥주사분타좌신0.2、0.4화0.8 mg/kg,Ⅰ조급여등용량생리염수,수후파공수주이병분,초시혈장파농도설위3.5μg/nl,채용서관법진행시험,대효응실농도여혈장농도체평형후5 min시행위경검사술,여발생양성발응,칙하일례환자이병분승고1개농도제도,반지강저1개농도제도,농도제도위0.3μg/ml,발생양성반응적표준위위경검사술과정중출현명현체동화/혹창해.채용개솔단위법계산파공수주이병분억제위경검사술반응적반수유효농도(EC50)급기95％가신구간(95％ CI).기록호흡억제화저혈압적발생정황.결과 Ⅰ조-Ⅳ조파공수주이병분억제위경검사술반응적EC50급기95％ CI분별위2.82(2.63～3.02) μg/ml、2.78(2.58～2.97)μg/ml、2.16(2.00～2.32)μg/ml화2.03(1.88 ～ 2.19) μg/ml.여Ⅰ조비교,Ⅲ조화Ⅳ조EC50강저,Ⅳ조호흡억제발생솔승고(P＜0.05).결론 분타좌신복합이병분용우노년환자위경검사술시적괄의제량위0.4 mg/kg.
Objective To determine the optimum dose of pentazocine when combined with propofol for gastroscopy in elderly patients.Methods One hundred and forty ASA physical status Ⅰ or Ⅱ patients,aged 6575 yr,scheduled for elective gastroscopy under general anesthesia,were randomly assigned into Ⅰ-Ⅳ groups (n =35 each) using a random number table.Before insertion of the gastroscope,pentazocine 0.2,0.4 and 0.8 mg/kg were injected intravenously in Ⅱ-Ⅳ groups,respectively,while the equal volume of normal saline was given in Ⅰ group.Propofol was then administered by target-controlled infusion (TCI).The half-effective concentration (EC50 of propofol was determined by up-and-down sequential trial.The target plasma concentration (Cp) was set at 3.5 μg/ml in the first patient.Gastroscopy was performed at 5 min after the target effect-site and plasma concentrations were balanced.The response to gastroscopy was defined as positive when body movement and/or bucking occurred during gastroscopy.Each time the Cp increased/decreased by 0.3 μg/ml in the next patient depending on whether or not the response to gastroscopy was positive.EC50 and 95 ％ confidence interval of propofol TCI inhibiting the response to gastroscopy were calculated using Probit analysis.The development of respiratory depression and hypotension was observed.Results EC50 (95 ％ confidence interval) of propofol TCI inhibiting the response to gastroscopy was 2.82 (2.63-3.02) μg/ml,2.78 (2.58-2.97) μg/ml,2.16 (2.00-2.32) μg/ml and 2.03 (1.88-2.19) μg/ml in Ⅰ-Ⅳ groups,respectively.Compared with group Ⅰ,EC50 was significantly decreased in Ⅲ and Ⅳ groups,and the incidence of respiratory depression was increased in Ⅳ group (P ＜ 0.05).Conclusion The optimum dose of pentazocine when combined with propofol is 0.4 mg/kg for gastroscopy in elderly patients.
