右美托咪啶辅助下异丙酚靶控输注抑制宫腔镜手术扩宫反应的半数有效浓度  

Median effective concentration of propofol target- controlled infusion assisted with dexmedetomidine for inhibiting response of dilatating uterus in hysteroscopic surgery

作　　者：张蓉[1] 张昆[1] 苗利萍[1] 陈亮[1] 

机构地区：[1]中山大学孙逸仙纪念医院,广东广州510120

出　　处：《吉林医学》2015年第14期2964-2966,共3页Jilin Medical Journal

摘　　要：目的：测定右美托咪啶辅助下异丙酚靶控输注抑制宫腔镜手术扩宫反应的半数有效浓度（EC50）。方法：择期宫腔镜手术患者20例,ASAⅠ~Ⅱ级,右美托咪啶0.6μg/kg剂量持续静脉输注10 min后,异丙酚靶控输注,待患者睫毛反射消失即开始手术,手术结束时停药。异丙酚的靶控浓度按序贯法确定,初始的靶控浓度定为4.5μg/ml,靶控浓度变化幅度定为0.5μg/ml。采用改良Dixon序贯法计算异丙酚靶控输注抑制宫腔镜手术扩宫反应的EC50及其95%可信区间,并采用logistic回归模型进行概率单位转换分析EC50及其95%可信区间。结果：右美托咪啶辅助下异丙酚靶控输注抑制宫腔镜手术扩宫反应的EC50为3.97μg/ml,其95%可信区间为（3.68~4.28）μg/ml。结论：利用序贯法测定静脉输注右美托咪啶0.6μg/kg后异丙酚靶控输注抑制宫腔镜手术扩宫反应的EC50为3.97μg/ml。Objective To determine the median effective concentration （EC50） of propofol target - controlled infusion assisted with dexmedetomidine for inhibiting response of dilatating uterus in hysteroscopic surgery. Method Twenty patients, ASA physical grading I or H, undergoing elective hysteroscopic surgery were enrolled in this study. After intravenous administration of 0. 6 μg/kg dexmedetomidine over 10 minutes, the target - controlled infusion of propofol was started until the end of surgery. The hysteroscopic surgery was started after the disap- pearance of eyelash reflex of patients. The target concentration of propofol was determined by modified Dixon＇s up- and - down sequential ex- periment. The initial target concentration of propofol was 4. 5 μg/ml, and the target concentration of propofol was increased or decreased by 0. 5μg/ml each time. If the response of dilatating uterus of a patient was positive, the target concentration given to the next patient was in- creased by 0. 5 μg/ml. If the response was negative,the target concentration given to the next patient was decreased by 0. 5 μg/ml. The EC50 and 95% confidence interval （95% CI） of propofol target - controlled infusion were calculated by the modified Dixon＇s up - and - down method, and the EC50 and 95% CI were also analyzed using the probit test in a logistic regression model. Results The EC50 of propofol target -controlled infusion assisted with dexmedetomidine for inhibiting response of dilatating uterus in hysteroscopic surgery was 3.97 μg/ml （95%CI 3.68 ~ 4. 28μg/ml）. Conclusion After intravenous administration of 0. 6 μg/kg dexmedetomidine, the EC50 of propofol target - controlled infusion for inhibiting response of dilatating uterus in hysteroscopic surgery obtained by modified Dixon＇s up - and - down method is 3.97 μg/ml.

关 键 词：右美托咪啶 异丙酚 靶控输注 宫腔镜手术 

分 类 号：R614[医药卫生—麻醉学]