脊柱侧弯矫形术患者术中唤醒试验成功时舒芬太尼的半数有效效应室靶浓度  

Median effective target effect-site concentration of sufentanil when intraoperative wake-up test was successful in patients undergoing scoliosis surgery

作　　者：麻伟青[1] 张承华[1] 杨云丽[1] 奚曦[1] 刘洁[1] 

机构地区：[1]成都军区昆明总医院麻醉科,昆明市650032

出　　处：《中华麻醉学杂志》2013年第1期46-48,共3页Chinese Journal of Anesthesiology

基　　金：云南省卫生厅基金资助项目（2011FZ317）

摘　　要：目的确定脊柱侧弯矫形术患者术中唤醒试验成功时舒芬太尼的半数有效效应室靶浓度（EC50）。方法拟在七氟醚．舒芬太尼复合麻醉下行脊柱侧弯矫形术患者90例，年龄18～64岁，BMI〈30kg／m2，ASA分级Ⅰ或Ⅱ级。采用分层随机法将患者分为6组（n=15）：Ⅰ组～Ⅵ组。各组均采用舒芬太尼、依托咪酯和顺阿曲库铵麻醉诱导，气管插管后机械通气，采用七氟醚、舒芬太尼和顺阿曲库铵维持麻醉。唤醒试验前停止输注顺阿曲库铵，下调七氟醚呼气末靶浓度至0，设定Ⅰ组唤醒试验时舒芬太尼Ce0．19ng／ml，Ⅱ组Ce0．18ng／ml，相邻两组Ce梯度为0．01ng／ml，每组依次递减。5min后开始唤醒。采用半数有效剂量试验设计寇氏法，计算舒芬太尼的EC50及其95％可信区间。结果脊柱侧弯矫形术患者术中唤醒试验成功时舒芬太尼的Ec。为0．164ng／ml，其95％CI为0．157～0．172ng／ml。结论脊柱侧弯矫形术患者术中唤醒试验成功时舒芬太尼的EC50为0．164ng／ml。Objective To determine the median effective target effect-site concentration （ECso） of sufentanil when intraoperative wake-up test was successful in patients undergoing scoliosis surgery. Methods Ninety ASA I or n patients, aged 18-64 yr, with body mass index 〈 30 kg/m2 , scheduled for scoliosis surgery under sevoflurane and sufentanil anesthesia, were randomly divided into I -VI groups （n = 15 each）. Anesthesia was induced with sufentanil, etomidate and cisatracurium, and maintained with sevoflurane, sufentanil and cisatracurium. The patients were tracheal intubated and mechanically ventilated. Before the wake-up test, infusion of cisatracurium was stopped and the end-tidal concentration of sevoflurane was adjusted to 0. The ECs0 was determined by the Karber method. The target effect-site concentration of sufentanil was set at 0.19 ng/ml in group I , 0.18 ng/ml in group II and gradually decreased in decrements of 0.01 ng/ml. The wake-up test was performed 5 rain later. The EC50 and 95 % confidence interval of sufentanil were calculated by the Karber method. Results ECs0 of sufentanil obtained was 0. 164 ng/ml and 95 % confidence interval of sufentanil obtained was 0. 157-0. 172 ng/ml when the wake-up test was successful. Conclusion The EC50 of sufentanil is 0. 164 ng/ml when the intraoperative wake-up test is successful in the patients undergoing scoliosis surgery.

关 键 词：舒芬太尼 药物释放系统 剂量效应关系 药物 

分 类 号：R614[医药卫生—麻醉学]