我国不同年龄男性小儿喉罩置入时七氟烷和丙泊酚的适宜浓度  

Optimal concentrations of sevoflurane and propofol for laryngeal mask airway insertion in Chinese boys of different ages

作　　者：李军[1] 叶莉莎[1] 高萍[1] 张旭彤[1] 徐坚[1] 苏尔瞻[1] 连庆泉[1] 

机构地区：[1]温州医学院附属二院、育英儿童医院麻醉科,325027

出　　处：《中华医学杂志》2009年第15期1012-1015,共4页National Medical Journal of China

摘　　要：目的探讨我国不同年龄男性小儿喉罩置入时七氟烷和丙泊酚的适宜浓度。方法择期美国麻醉医师协会（ASA）Ⅰ级、体重7～53kg男性小儿腹股沟手术200例，按年龄分为7个月～1岁（A组）、1～3岁（B组）、4—6岁（C组）、7～11岁（D组）4组，n=50。不用术前用药，常规禁食禁饮。喉罩置入采用七氟烷＋50％N2O吸入麻醉（As、Bs、Cs、Ds，n=25）或丙泊酚效应室浓度TCI静脉麻醉（Ap、Bp、Cp、Dp，n=25）。8组均根据Dixon序贯法来确定喉罩置入时的适宜浓度，在患儿下颌松弛、睫毛反射及咽喉反射消失时用翻转法置入喉罩。结果As、Bs、Cs、Ds组喉罩置入时呼末七氟烷浓度的ED50各为2．96％（95％CI2．58％～3．44％）、2．62％（95％CI2．31％-2．90％）、2．16％（95％CI1．97％～2．33％）及1．89％（95％CI1．66％～2．24％）；Ap、Bp、Cp、Dp组喉罩置入时丙泊酚效应室浓度的ED50各为4．74μg/ml（95％CI4．49～5．13μg/ml）、4．33μg／ml（95％CI4．07～4．62μg/ml）、4．10μg／ml（95％CI3．90—4．31μg/ml）及3．65μg/ml（95％CI3．24～3．98μg／ml）。结论喉罩置入时呼末七氟烷浓度及丙泊酚效应室浓度的ED0随着男性小儿年龄增加而逐步减少。Objective To investigate the optimal concentrations of sevoflurane and propofol for laryngeal mask airway （LMA） insertion in Chinese boys of different ages. Methods 200 boys with ASA status I weighting 7 - 53 kg undergoing inguinal operation were divided into 4 groups （ n = 50） according to age： Group A （aged 7m-1yr）, Group B （1-3 yrs）, Group C （4-6 yrs）, and Group D （7-11 yrs）. No premedication was given. General anesthesia was induced with propofol intravenous infusion at target effect-site concentration by target controlled infusion （TCI） using children Marsh model （Subgroups As, Bs, Cs, and Ds, 25 cases for each subgroup）or sevoflurane inhalation combined with 50% N2O（ Subgroups Ap, Bp, Cp, and Dp, 25 cases for each subgroup）the optimal concentration was predetermined according to the modification of Dixon＇s up-and-down method. The size of LMA was determined according to the boy＇s weight and reverse technique was used to place LMA. The insertion conditions were noted as satisfactory when the jaw was relaxed, lash reflex disappeared, no coughing, gagging, swallowing, and laryngospasm was seen, and limb movement was minimal. Results The levels of ED50 of PET-sevoflurane for LMA insertion in Subgroups As, Bs, Cs, and Ds were 2. 96% （95% CI2.58% -3.44%）, 2. 62% （95% C12.31% - 2. 90% ）, 2. 16% （95% CI 1.97% -2. 33% ）, and 1.89% （95% CI 1.66% -2. 24% ）respectively. The levels of ED50 of target effect site concentration with propofol for LMA insertion in Subgroups Ap, Bp, Cp, and Dp were 4. 74 μg/ml （ 95% CI 4. 49 - 5.13 μg/ml ）, 4. 33 μg/ml （ 95% CI 4. 07 - 4. 62 μg/ml ）, 4.10 μg/ml （95% CI 3.90 - 4. 31 μg/ml）, and 3.65 μg/ml （95% CI 3.24 - 3.98 μg/ml） respectively. Conclusion The ED50 level of PET-sevotlurane or target effect site concentration with propofol for LMA insertion in Chinese boys decreases gradually along with the increase of age.

关 键 词：喉罩 麻醉 七氟烷 丙泊酚 儿童 

分 类 号：R686[医药卫生—骨科学]