靶控输注瑞芬太尼引起呼吸抑制的半数有效血浆靶浓度的研究  

Study of the half-effective target plasma concentration of respiratory depression induced by target-controlled infusion of remifentanil

作　　者：莫利群[1] 曹露[1] 吴刚明[1] 

机构地区：[1]泸州医学院附属医院麻醉科,四川泸州646000

出　　处：《实用医院临床杂志》2015年第1期74-76,共3页Practical Journal of Clinical Medicine

摘　　要：目的：探讨靶控输注（ TCI）瑞芬太尼引起清醒患者呼吸抑制的半数有效血浆靶浓度（ Cp50）。方法择期全麻手术患者28例，按照Dixon序贯法进行试验，TCI瑞芬太尼的起始靶浓度为5.0 ng／ml，血浆靶浓度由高到低设为5.0、4.5、4.0、3.5、3.0和2.5 ng／ml，下一例患者瑞芬太尼血浆靶浓度由上一例结果决定，增加或降低0.5 ng／ml输注。应用Probit检验计算瑞芬太尼的Cp50及95％可信区间（95％CI）。结果16例患者出现呼吸抑制，以呼吸频率（RR）降低、血氧饱和度（SpO2）下降为主要表现。瑞芬太尼的Cp50为3.26 ng／ml，其95％CI为1.75～3.97 ng／ml。结论 TCI瑞芬太尼引起清醒患者呼吸抑制的Cp50为3.26 ng／ml。Objective To investigate the half-effective target plasma concentration（ Cp50 ） of respiratory depression induced by target-controlled infusion（ TCI） of remifentanil in awake patients.Methods Twenty-eight patients undergoing elective surgery with gen-eral anesthesia were studied according to Dixon sequential method.The initial target plasma concentration of remifentanil was set at 5.0 ng/ml.From high to low,the target plasma concentrations were designed as 5.0,4.5,4.0,3.5,3.0 and 2.5 ng/ml.The next target plasma concentration was determined according to the response of the previous patient by increasing or decreasing 0.5 ng/ml.The re-spiratory depression Cp50and 95%confidence interval（95%CI）of remifentanil were determined by the probit analysis.Results There were 16 patients showing respiratory depression that was mainly manifested as a decrease in RR or SpO2 .The average Cp50 of remifen-tanil was 3.26 ng/ml（95%CI 1.75~3.97 ng/ml） .Conclusion The respiratory depression Cp50 of TCI remifentanil was 3.26 ng/ml in awake patients.

关 键 词：瑞芬太尼 靶控输注 呼吸 血浆靶浓度 

分 类 号：R614.2[医药卫生—麻醉学]