右美托咪定对舒芬太尼抑制经尿道前列腺电切术患者尿道镜置入反应半数有效效应室靶浓度的影响  

Influence of on median effective target effect-site concentration of sufentanil- inhibiting urethroscope insertion response in patients undergoing transurethral resection of prostate

作　　者：周卫民[1] 李建军[1] 

机构地区：[1]武汉市汉口医院麻醉科,430012

出　　处：《中国医师进修杂志》2012年第21期11-13,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价右美托咪定对舒芬太尼抑制经尿道前列腺电切术（TURP）患者尿道镜置入反应的半数有效效应室靶浓度（EC50）的影响。方法选取择期行TURP的患者40例，ASA分级Ⅰ～Ⅱ级。采用随机数字表法分为两组，每组20例。右美托咪定组超过10min静脉输注右美托咪定0．6μs／kg，对照组给予等容量0．9％氯化钠，停止给药5min时开始靶控输注丙泊酚，血浆靶浓度为3．0μg／m，输注10min时，两组开始靶控输注舒芬太尼，初始效应室靶浓度为0．20ng／ml。根据患者是否发生尿道镜置入反应确定下一例患者舒芬太尼的靶浓度，相邻靶浓度比值为1．1。计算舒芬太尼抑制尿道镜置入反应的EC50及其95％可信区间（95％CI）。结果右美托咪定组最终入选20例，对照组最终入选19例。两组患者术中心电图ST段绝对值、收缩压、心率、脉搏血氧饱和度和脑电双频指数比较差异无统计学意义（P〉0．05）。右美托咪定组舒芬太尼抑制尿道镜置入反应的EC50为0．1148ng／ml（95％CI 0．1055．0．1249ng／ml），明显低于对照组的0．1454ng／ml（95％CI 0．1339～0．1580ng/ml），差异有统计学意义（P〈0．05）。结论术前静脉输注右美托咪定0．6μg／kg可降低舒芬太尼抑制TURP患者尿道镜置入反应的EC50。Objective To evaluate the influence of dexmedetomidine on median effective target effect-site concentration（EC50） of sufentanil-inhibiting urethroseope insertion response in patients undergoing transurethral resection of prostate （TURP）. Methods Forty patients with ASA grading Ⅰ - Ⅱ who accepted selective TURP were divided by random digits table method into two groups with 20 cases each. The patients in dexmcdetomidine group were treated with 0.6 μg/kg dexmedetomidine intravenous infusion for more than 10 min,while control group were treated with equivalent capacity of 0.9% sodium chloride. At 5 min after stopping injection, target-controlled infusion of propofol was started and the plasma target concentration was 3.0 μg/ml. At 10 min after infusion,target-controlled infusion of sufentanil began and the plasma target concentration was 0.20 ng/ml. The target concentration of sufentanil of the next patient accorded to the patient with or without the urethroscope insertion response and the adjacent rate of the target concentration was 1.1. The EC50 and 95% confidence interval （CI） of sufentanil were calculated. Result There were 20 cases in dexmedetomidine group ultimately selected and 19 cases in control group. There was no statistical significance in absolute value of ST segment of intraopcrative electrocardiogram, systolic blood pressure, heart rate, pulse oxygen saturation and bispectral index between two groups （P 〉0.05）. EC50 of sufentanil-inhibiting urethroscope insertion response in dexmedetomidine group was 0. 1148 ng/ml （95% CI 0.1055 - 0.1249 ng/ml） ,which was significantly lower than that in control group [0.1454 ng/ml （95% CI 0.1339 -0.1580 ng/ml）] （P 〈0.05）. Conclusions 0.6 μg/kg dexmedetomidine intravenous infusion before operation can reduce the EC50 of sufentaniMnhibiting urethroscope insertion response in patients undergoing TURP.

关 键 词：右美托咪啶 舒芬太尼 药物释放系统 剂量效应关系 药物 经尿道前列腺 切除术 

分 类 号：R614[医药卫生—麻醉学]