靶控输注瑞芬太尼抑制气管拔管期呛咳反应的临床研究  

Clinical study on target-controlled infusion of remifentanil for preventing cough during tracheal extubation

作　　者：宁慧杰[1] 陈巍[1] 李永华[1] 田谋利[1] 朱秋峰[1] 石学银[1] 

机构地区：[1]第二军医大学附属长征医院麻醉科,上海市200003

出　　处：《临床麻醉学杂志》2012年第7期669-671,共3页Journal of Clinical Anesthesiology

摘　　要：目的测定瑞芬太尼抑制50%及95%患者拔管期呛咳反应的效应室浓度(EC_(50)及EC_(95)),为其应用于全身麻醉苏醒期拔管管理提供可靠依据和合适的药物浓度。方法 23例ASAⅠ或Ⅱ级全身麻醉下行颈前路减压植骨内固定术男性患者,用Dixons序贯法和Probit分析确定瑞芬太尼抑制呛咳反应的EC_(50)、EC_(95)及其各自的95%可信区间(95%CI)。结果根据Probit分析计算瑞芬太尼抑制患者拔管期呛咳反应的EC_(50)为1.67ng/ml(95%CI为1.44～1.96ng/ml),EC_(95)为2.13ng/ml(95%CI为1.89～3.34ng/ml)。结论全麻拔管期抑制患者呛咳反应的瑞芬太尼EC_(95)为2.13ng/ml,维持此浓度靶控输注(TCI)可安全、有效地消除呛咳,改善全麻苏醒质量。Objective To investigate the EC50 and EC95 of remJfentanil for preventing cough during tracheal extubation, and provide a reliable and appropriate medication concentration during extubation, Methods Twenty three male patients, ASA I or II grade, undergoing arterior cervical surgery under general anesthesia were enrolled in this study. EC50, EC95 and its own 95% CI of remifentanil for preventing cough were determined using Dixon＇s sequential method and probit analysis. Results EC50 of remifentanil suppressed coughing was 1.67 ng/ml（95% CI was 1.44-1.96 ng/ml） and EC95 was 2. 13 ng/ml （95% CI was 1.89-3.34 ng/ml）. Conclusion During tracheal extubation, EC95 of remifentanil suppressed coughing is 2. 13 ng/ml. It is a safe and effective method of prevent coughing and thereby improve the quality of emergence from anesthesia.

关 键 词：靶控输注 瑞芬太尼 并发症 气管拔管 

分 类 号：R614[医药卫生—麻醉学]