置入SLIPA喉罩和LMA喉罩时瑞芬太尼量效关系的研究  

Study of dose-effect relationship of Remifentanil for SLIPA with LMA insertion

作　　者：叶晓明[1] 叶军青[1] 徐海涛[1] 袁红斌[1] 

机构地区：[1]解放军第二军医大学长征医院麻醉科,上海200003

出　　处：《临床军医杂志》2013年第2期163-165,186,共4页Clinical Journal of Medical Officers

摘　　要：目的观察并比较在靶控输注相同丙泊酚效应室浓度下,置入SLIPA喉罩和传统LMA喉罩所需的瑞芬太尼效应室浓度。方法将40例择期行输尿管镜碎石术的患者随机分成S组和L组;S组置入SLIPA,L组置入LMA。两组均采用Marsh药代动力学模型以4.0μg/ml的效应室浓度靶控输注丙泊酚5 min后,运用改良的Dixon’s上下序贯法,采用Minto药代动力学模型靶控输注瑞芬太尼,5 min后置入喉罩。采用probit法计算出S组和L组所需瑞芬太尼的半数有效剂量(ECe50)。结果 S组患者瑞芬太尼的ECe50为3.25 ng/ml(95%CI 2.86～3.43 ng/ml),L组患者瑞芬太尼的ECe50值为2.97 ng/ml(95%CI 2.82～3.22 ng/ml)。结论在不使用肌松剂的情况下,相同丙泊酚效应室浓度下置入SLIPA喉罩和LMA喉罩,SLIPA喉罩所需的瑞芬太尼效应室浓度要高于传统LMA喉罩。Objective To compare the effect-site concentration of Remifentanil for streamlined liner of the pharynx airway （SLIPA） with laryngeal mask airway （LMA） insertion during target-controlled infusion （TCI） of Propofol, without a neuromuscular blocking agent. Methods Forty selective patients undergoing ureteroscopic lithotripsy were randomly assigned into Group S that received SLIPA insertion and Group L that received LMA insertion （n = 20/group）. All the patients were given Propofol in Marsh model at 4.0μg/ml by TCI. Five minutes after Propofol infusion, Remifentanil was infused in Minto model by TCI with a dose determined by a modified Dixon＇ s up-and-down method. Five minutes after Remifentanil infusion, SLIPA or LMA was inserted. By means of probit analysis, the median effective dose （ EC%0 ） of Remifentanil for Group S and L were calculated, respectively. Results ECe50 of Remifentanil was 3.25 ng/ml in Group S （95% CI 2.86 - 3.43 ） and 2.97 ng/ml in Group L （95% CI 2.82 - 3.22 ）. Conclusion The effect-site concentration of Remifentanil for SLIPA insertion during TCI of Propofol is higher than that for LMA, without a neuromuscular blocking agent.

关 键 词：喉罩 瑞芬太尼 靶控输注 半数有效浓度 输尿管镜 

分 类 号：R971.2[医药卫生—药品]