依托咪酯和七氟醚诱导对血流动力学的影响  

Hemodynamic changes following induction of anesthesia with etomidate and sevoflurane

作　　者：史东平[1] 封卫征[1] 王珊娟[2] 杭燕南[2] 

机构地区：[1]上海交通大学医学院仁济医院嘉定分院麻醉科,上海201800 [2]上海交通大学医学院仁济医院麻醉科,上海200001

出　　处：《上海交通大学学报（医学版）》2008年第9期1149-1152,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨依托咪酯和七氟醚用于麻醉诱导时对血流动力学影响的相互作用性质。方法24例腹部手术行全身麻醉患者，接受靶控输注效应位浓度的依托咪酯（0～0．5μg／mL）和吸入七氟醚（1％～5％），在每个目标浓度稳态水平，测定并记录平均动脉压（MAP）、心率（HR）以及其它重要生命体征。反应曲面药效学相互作用模型用于拟合MAP单纯集合数据，确定相互作用的性质。结果相互作用指数γ（决定药物相互作用的性质和幅度）为1．7（P〈0．05），依托咪酯协同性减少七氟醚降低平均动脉压的需要量。结论反应曲面分析提示依托咪酯和七氟醚用于麻醉诱导对血流动力学的影响表现为协同作用。Objective To characterize the nature of interaction with hemodynamics between etomidate and sevoflurane in anesthesia induction. Methods Twenty-four patients received a target-controlled infusion of etomidate （0-0.5 mg/mL） and inhaled sevoflurane （1%- 5% ） at various target concentration pairs. After reaching pseudo-steady state drug levels, the mean blood pressure （MAP）, heart rate （HR） and other vital signs were observed for each target concentration pair. Response surface pharmacodynamic interaction models were built using the pooled data of MAP to identify the nature of interaction. Results The interaction index γ, which characterized the magnitude and type of interaction, was 1.7 （P 〈 0.05） for response of MAP decreasing. Etomidate synergistically decreased the amount of sevoflurane necessary to produce MAP decreasing. Conclusion Response surface analyses demonstrate a synergistic interaction between etomidate and sevoflurane for hemodynamic function.

关 键 词：依托咪酯 七氟醚 药效学 相互作用 

分 类 号：R614.2[医药卫生—麻醉学] R331.3[医药卫生—外科学]