经皮穴位电刺激对瑞芬太尼抑制气管插管反应EC_(50)的影响  

Impacts of the transcutaneous electrical acupoint stimulation on EC_(50) in the remifentanil inhibition of tracheal intubation response

作　　者：黄笑玉 潘飞鹏 招伟贤 

机构地区：[1]广州中医药大学第二附属医院麻醉科,广东广州510120

出　　处：《中国针灸》2015年第8期812-815,共4页Chinese Acupuncture & Moxibustion

基　　金：广东省中医药局基金资助项目:20131192

摘　　要：目的：观察经皮电刺激（TEAS）合谷、内关穴对瑞芬太尼抑制气管插管反应半数有效效应室浓度（EC50）的影响,探讨TEAS对插管应激反应的抑制效果。方法：40例静脉全身麻醉气管插管择期手术患者,美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级,随机分为观察组和对照组,每组20例。全麻诱导前观察组经皮电刺激双侧合谷、内关穴30 min,波型选用疏密波,频率2 Hz/100Hz;对照组在穴位上假刺激,刺激仪仅有灯亮,未有电流输出,之后进行静脉全麻诱导,当丙泊酚与瑞芬太尼的靶浓度稳定于预先设定值,行气管插管。采用Dixon序贯法测定瑞芬太尼抑制气管插管反应EC50。结果：观察组瑞芬太尼抑制气管插管反应EC50为3.46ng/mL,95%置信区间为2.80～4.27ng/mL;对照组为4.18ng/mL,95%置信区间为3.30～5.29ng/mL,两组比较差异有统计学意义（P〈0.01）。结论：经皮穴位电刺激可明显降低瑞芬太尼抑制气管插管反应EC50,降幅约为17%。Objective To explore the impacts on EC50 in the remifentanil inhibition of tracheal intubation response by the transcutaneous electrical acupoint stimulation（TEAS）at Hegu（LI 4）and Neiguan（PC 6）.Methods Forty patients with selective surgery undergoing endotracheal intubation with intravenous general anesthesia were divided intoⅠtoⅡ degree by the American Society of Anesthesiologists（ASA）and were randomized into an observation group and a control group,20 cases in each one.Before general anesthesia induction,in the observation group,the transcutaneous electric stimulation was applied to bilateral Hegu（LI 4）and Neiguan（PC 6）for30min,with dense-disperse wave,2Hz/100 Hz in frequency;in the control group,the sham-stimulation was applied to the acupoints,with the lamp on,but without electric current output.Afterwards,the general anesthesia induction started.When the target concentration of propofol and remifentanil was stabilized at the preset value,the endotracheal intubation was conducted.Dixon sequential method was applied for the determination of EC50 in remifentanil inhibition of tracheal intubation response.Results The level of EC50 in remifentanil inhibition of tracheal intubation response was 3.46ng/mL,95% confidence interval was 2.80ng/ml to 4.27ng/mL in the observation group;those were 4.18ng/mL and 3.30ng/mL to 5.29ng/mL in the control group separately.The differences were significant in comparison of the two groups（P〈0.01）.Conclusion TEAS apparently reduces EC50 in the remifentanil inhibition of tracheal intubation response by around 17%.

关 键 词：气管插管 经皮穴位电刺激 瑞芬太尼 序贯试验法 EC50 

分 类 号：R246.2[医药卫生—针灸推拿学]