中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2014年
12期
1455-1457
,共3页
郑耀明%刘克玄%于永群%瞿波%陈旭华%容颖雅%胡胜英%方锐伦
鄭耀明%劉剋玄%于永群%瞿波%陳旭華%容穎雅%鬍勝英%方銳倫
정요명%류극현%우영군%구파%진욱화%용영아%호성영%방예륜
右美托咪啶%依托咪酯%剂量效应关系,药物
右美託咪啶%依託咪酯%劑量效應關繫,藥物
우미탁미정%의탁미지%제량효응관계,약물
Dexmedetomidine%Etomidate%Dose-response relationship,drug
目的 探讨复合依托咪酯时右美托咪定用于患者麻醉诱导的适宜剂量.方法 择期全麻手术患者100例,年龄18～60岁,ASA分级Ⅰ或Ⅱ级,BMI 20～25 kg/m2,采用随机数字表法分为5组(n=20):对照组(C组)和不同剂量右美托咪定组(D0.2组、D0.4组、D06组和D08组).经10 min静脉输注50 ml生理盐水(C组)、右美托咪定0.2 μg/kg(D0.2组)、0.4 μg/kg(D0.4组)、0.6 μg/kg(D06组)和0.8μg/kg(D0.8组)后,TCI依托咪酯,初始血浆靶浓度为0.5ug/ml,于TCI开始8 min时进行改良镇静/警觉评分,评分≤3分认为意识消失.采用序贯法进行试验,计算依托咪酯使患者意识消失的半数有效血浆靶浓度(EC50).记录右美托咪定给药后低血压、心动过缓的发生情况.结果 与C组比较,其余组依托咪酯使患者意识消失的EC50降低(P＜0.05),D02组、D0.4组、D06组依托咪酯使患者意识消失的EC50逐渐降低(P＜0.05),D06组与D0.8组依托咪酯使患者意识消失的EC50比较差异无统计学意义(P＞ 005).C组、D0.2组、D04组和D06组均未见低血压和心动过缓发生,D0.8组低血压发生率为12％,心动过缓发生率为19％.结论 复合依托咪酯时右美托咪定用于患者麻醉诱导的适宜剂量为0.6ug/kg.
目的 探討複閤依託咪酯時右美託咪定用于患者痳醉誘導的適宜劑量.方法 擇期全痳手術患者100例,年齡18～60歲,ASA分級Ⅰ或Ⅱ級,BMI 20～25 kg/m2,採用隨機數字錶法分為5組(n=20):對照組(C組)和不同劑量右美託咪定組(D0.2組、D0.4組、D06組和D08組).經10 min靜脈輸註50 ml生理鹽水(C組)、右美託咪定0.2 μg/kg(D0.2組)、0.4 μg/kg(D0.4組)、0.6 μg/kg(D06組)和0.8μg/kg(D0.8組)後,TCI依託咪酯,初始血漿靶濃度為0.5ug/ml,于TCI開始8 min時進行改良鎮靜/警覺評分,評分≤3分認為意識消失.採用序貫法進行試驗,計算依託咪酯使患者意識消失的半數有效血漿靶濃度(EC50).記錄右美託咪定給藥後低血壓、心動過緩的髮生情況.結果 與C組比較,其餘組依託咪酯使患者意識消失的EC50降低(P＜0.05),D02組、D0.4組、D06組依託咪酯使患者意識消失的EC50逐漸降低(P＜0.05),D06組與D0.8組依託咪酯使患者意識消失的EC50比較差異無統計學意義(P＞ 005).C組、D0.2組、D04組和D06組均未見低血壓和心動過緩髮生,D0.8組低血壓髮生率為12％,心動過緩髮生率為19％.結論 複閤依託咪酯時右美託咪定用于患者痳醉誘導的適宜劑量為0.6ug/kg.
목적 탐토복합의탁미지시우미탁미정용우환자마취유도적괄의제량.방법 택기전마수술환자100례,년령18～60세,ASA분급Ⅰ혹Ⅱ급,BMI 20～25 kg/m2,채용수궤수자표법분위5조(n=20):대조조(C조)화불동제량우미탁미정조(D0.2조、D0.4조、D06조화D08조).경10 min정맥수주50 ml생리염수(C조)、우미탁미정0.2 μg/kg(D0.2조)、0.4 μg/kg(D0.4조)、0.6 μg/kg(D06조)화0.8μg/kg(D0.8조)후,TCI의탁미지,초시혈장파농도위0.5ug/ml,우TCI개시8 min시진행개량진정/경각평분,평분≤3분인위의식소실.채용서관법진행시험,계산의탁미지사환자의식소실적반수유효혈장파농도(EC50).기록우미탁미정급약후저혈압、심동과완적발생정황.결과 여C조비교,기여조의탁미지사환자의식소실적EC50강저(P＜0.05),D02조、D0.4조、D06조의탁미지사환자의식소실적EC50축점강저(P＜0.05),D06조여D0.8조의탁미지사환자의식소실적EC50비교차이무통계학의의(P＞ 005).C조、D0.2조、D04조화D06조균미견저혈압화심동과완발생,D0.8조저혈압발생솔위12％,심동과완발생솔위19％.결론 복합의탁미지시우미탁미정용우환자마취유도적괄의제량위0.6ug/kg.
Objective To investigate the optimum dose of dexmedetomidine for inductionof anesthesia when combined with etomidate.Methods One hundred ASA physical status Ⅰ or Ⅱ patients,aged 18-60 yr,with body mass index of 20-25 kg/m2,scheduled for elective surgery under general surgery,were randomly divided into 5 groups (n =20 each) using a random number table:control group (group C) and different doses of dexmedetomidine groups (D0.2,D0.4,D0.6 and D0.8 groups).Norud saline 50 ml and dexmedetomidine 0.2,0.4,0.6 and 0.8 μg/kg were infused intravenously over 10 min in C,D0.2,D0.4,D0.6 and D0.8 groups,respectively.At the end of infusion,etomidate target-controlled infusion was started with the initial target plasma concentration of 0.5 μg/ml.Modified OAA/S score was recorded at 8 min of target-controlled infusion.OAA/S score ≤ 3 was considered as loss of consciousness.Dixon' s up-and-down technique was used for test.The median effective concentration (EC50) of etomidate required for inducing loss of consciousness was calculated.The development of hypotension and bradycardia after dexmedetomidine administration was recorded.Results Compared with group C,the EC50 of etomidate required for inducing loss of consciousness was significantly decreased in D0.2,D0.4,D0.6 and D0.8 groups.The EC50 of etomidate required for inducing loss of consciousness was decreased gradually with the increasing doses of dexmedetomidine in D0.2,D0.4 and D0.6 groups.There was no significant difference in the EC50 of etomidate required for inducing loss of consciousness between D0.6 and D0.8 Voups.No hypotension and bradycardia occurred in C,D0.2,D0.4,and D0.6 groups.The incidence of hypotension was 12％,and the incidence of bradycardia was 19％ in D0.8 group.Conclusion When combined with etomidate,the optimum dose of dexmedetomidine is 0.6 μtg/kg for induction of anesthesia.
