右美托咪定复合颈丛麻醉镇静镇痛的半数有效剂量  

Median effective dose of dexmedetomidine compound with cervical plexus anesthesia for sedation and analgesia

作　　者：刘毅[1] 杨承祥[2] 仲吉英[2] 张娜[1] 文先杰[2] 周桥灵[2] 

机构地区：[1]徐州医学院麻醉学教研室,江苏徐州221004 [2]佛山市第一人民医院麻醉科,广东佛山528000

出　　处：《中国新药与临床杂志》2012年第11期693-696,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探讨右美托咪定复合颈丛麻醉镇静镇痛的半数有效剂量(ED_(50))。方法 80例择期行甲状腺次全切除术患者,随机分成镇静组和镇痛组,每组40例。各患者的药物剂量以序贯法进行选择,右美托咪定的初始负荷剂量设为1μg·kg^(-1),递增递减的梯度标准为0.1μg·k^(-1),区间为0.50～1.50μg·kg^(-1)。泵注时间为10 min,泵注完毕后10 min开始手术。分别以Ramsay评分和VAS评分作为镇静和镇痛的评分。采用序贯法计算2组右美托咪定的ED_(50)及其95%可信区间(CI)。观察2组生命体征及不良反应。结果镇静组右美托咪定的ED_(50)为1.16μg·kg^(-1)(95%CI:0.98～1.34μg·kg^(-1)),镇痛组为0.81μg·kg^(-1)(95%CI:0.67～0.95μg·kg^(-1))。2组入室后、选取颈丛阻滞后10 min、泵注完成后10 min时平均动脉压和心率无显著差异(P>0.05),切皮、牵拉甲状腺上极、缝皮时镇痛组平均动脉压和心率均较泵注完成后10 min有所上升,且高于镇静组,差异均有显著意义(P<0.05)。结论右美托咪定复合颈丛麻醉时镇静和镇痛的ED_(50)分别为1.16μg·kg^(-1)和0.81μg·kg^(-1),以前者为最佳剂量。AIM To investigate the median effective dose （ED50） of dexmedetomidine compound wlm cervical plexus anesthesia for sedation and analgesia. METHODS Eighty patients undergoing subtotal thyroidectomy surgery were randomly allocated into sedation or analgesia group with 40 in each. With sequential method, the patients were given dexmedetomidine in an initial loading dose of 1 μg. kg-1 and each adjacent level dose was 0.1 μg.kg-1. The dose of dexmedetomidine ranged from 0.50 to 1.50 μg.kg-1, pumping for 10 rains.The surgery started 10 rains after pumping finished. Ramsay score and VAS score were used to assess the calm and analgesic level. Sequential method was used to calculate the ED50 and 95% confidence interval （CI）. The vital signs and adverse reactions were observed. RESULTS The ED50 of dexmedetomidine in the sedation group was 1.16 μg.kg-1 （95% CI： 0.98 - 1.34 μg.kg-1） . The ED50 of dexmedetomidine in the analgesia group was 0.81 μg.kg-1 （95% CI： 0.67 - 0.95 μg.kg-1）. There was no difference in mean arterial pressure （MAP） and heart rate （HR） after the burglary, 10 min after cervical plexus block, 10 min after pump injection complete between two groups （P 〉 0.05）. Compared with those at the 10 rain after pump injection complete, the levels of MAP and HR of the analgesia group increased at the incision, pulling the superior thyroid pole and the skin closure, and were higher than those in the sedation group （P 〈 0.05）. No serious adverse reactions occurred in both groups. CONCLUSION The ED50 of dexmedetomidine compound with cervical plexus anesthesia for sedation care and analgesia are 1.16 μg.kg-1 and 0.81 μg.kg-1, and the optimal dose is the former.

关 键 词：右美托咪定 镇痛 镇静 颈丛 半数有效剂量 

分 类 号：R971[医药卫生—药品]