靶控输注瑞芬太尼抑制哈尼族患者气管插管及切皮反应的半数有效血浆浓度  

Effect of target-controlled infusion of remifentanil in inhibition of the median effective plasma concentration of Hani patients undergoing endotracheal intubation and skin Incision

作　　者：税昌中 

机构地区：[1]云南省红河州第一人民医院麻醉科,蒙自661199

出　　处：《右江医学》2014年第1期41-43,47,共4页Chinese Youjiang Medical Journal

摘　　要：目的 探讨哈尼族患者复合异丙酚时,血浆靶控输注瑞芬太尼抑制气管插管及切皮反应的半数有效血浆浓度（EC50）.方法 择期手术患者50例,靶控输注异丙酚（3.0 μg/ml）及瑞芬太尼（2.6 ng/ml）,患者意识消失（睫毛反射消失和对言语指令无反应）时静注阿曲库铵,待血浆靶控浓度（Cp）与效应室浓度（Ce）达平衡,BIS值为40～50时行气管插管.瑞芬太尼Cp按序贯法确定,浓度梯度为0.5 ng/ml.结果采用半数效量序贯法公式计算患者复合异丙酚时,血浆靶控输注瑞芬太尼抑制气管插管的EC50为3.09 ng/ml,95%可信区间（CI）为2.05～4.13 ng/ml,抑制切皮反应的EC50为 3.24 ng/ml,95%可信区间（CI）为2.20～4.27 ng/ml.结论血浆靶控输注异丙酚3.0 μg/ml时,瑞芬太尼抑制哈尼族患者气管插管的EC50为3.09 ng/ml,抑制切皮反应的EC50为3.24 ng/ml.Objective To investigate the effect of target-controlled infusion of remifentanil in inhibition of median effective plasma concentration（ECs0）of HaM patients when undergoing endotracheal intubation and skin incision with composite propofol. Methods 50 patients undergoing operation were given 3.0 μg/ml of propofol and 2.6 ng/ml of remifentanil by target-controlled infusion. All patients were given intravenous injection of atracurium when they lost consciousness-no eyelash reflex and no response to language command.Moreover, when their target-controlled plasma concentration （Cp） and effect-site plasma concentration （Ce） reached to equilibration and BIS value was maintained between 40 and 50, patients were given endotraeheal intubation. Cp of remifentanil were determined by sequential method with a concentration gradients of 0.5 ng/ml.Results When the median effective sequential method was used to calculate the patients＇ composite propofol, the EC50 inhibited by target-controlled infusion of remifentanil during endotracheal intubation was 3.09 ng/ml,and 95% of confidence interval（CI）was 2.05-4.13 ng/ml.The EC50 inhibi ting the response of skin incision was 3.24 ng/ml and 95 % of confidence interval（CI）was 2.20-4.27 ng/mLConelusion When giving 3.0 μg/ml of propofol by target controlled infusion,the EC50 of target controlled infused remifentanil inhibiting endotracheal intubation in Hani patients is 3.09 ng/ml,and that of inhibiting response of skin incision is 3.24 ng/ml.

关 键 词：哈尼族 哌啶类 二异丙酚 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]