与瑞芬太尼联用时七氟烷抑制小儿纤维支气管镜置入反应的半数和95％效应浓度  

Half and 95 % effective concentration of sevoflurane combined with remifentanil in inhibiting insertion response of fiberoptic bronchoscopy in children

作　　者：祁宾[1] 张志捷[1] 

机构地区：[1]南京医科大学附属淮安第一医院麻醉科,223300

出　　处：《中国医药》2015年第12期1838-1840,共3页China Medicine

摘　　要：目的探讨与瑞芬太尼联用时七氟烷抑制小儿纤维支气管镜置入反应的半数效应浓度（EC50）和95％效应浓度（EC95）。方法选择南京医科大学附属淮安第一医院2014年12月至2015年3月美国麻醉医师学会Ⅰ或Ⅱ级，年龄3～12岁拟行喉罩下全身麻醉患儿，采用8％七氟烷潮气量诱导法后缓慢静脉注射瑞芬太尼1．5μg/kg，随后持续泵注瑞芬太尼0．03—0．06μg/（kg·min），待脑电双频指数（BIS）达到50—65时置入喉罩，“T型”密封接头连接喉罩与麻醉环路。根据改良Dixon序贯法确定潮气末七氟烷浓度，达预定值并稳定15min后纤维支气管镜经喉罩进入气管及支气管，置入过程患儿躯干、四肢及头颈有可见的肌束收缩为置入反应阳性，否则为阴性。计算联合瑞芬太尼时七氟烷抑制小儿纤维支气管镜置入反应的EC50、EC95，及相应的95％置信区间（CI）。结果本研究共纳入患儿22例。联合瑞芬太尼时七氟烷抑制小儿纤维支气管镜置入反应的EC50为2．30％，95％CI：2．08％-2．46％；EC95为2．56％，95％CI：2．42％～3．74％。结论联合瑞芬太尼时七氟烷抑制小儿纤维支气管镜置入反应的EC50为2．30％，EC95为2．56％。Objective To investigate the half effective concentration （EC50） and 95% effective concentration （EC95） of sevoflurane combined with remifentanil in inhibiting insertion response of fiberoptic bronchoscopy in children. Methods The patients aged 3-12 years with American society of anesthesiologists Ⅰ or Ⅱ who underwent general anesthesia with laryngeal mask airway （LMA） from December 2014 to March 2015 were enrolled. Anesthesia was induced with tidal volume inhalation of 8 % sevoflurane, then 1.5 μg/kg remifentanil was intravenously infected, followed by maintain infusion [0. 03-0. 06 μg/（ kg · min） ] ; the LMA was inserted and combined with anesthesia breathing circuit through T-seal adapter when bispectral index get to 50-65. The end-tidal concentration of sevoflurane was determined according to Dixon＇s up-and-down methods; the fiberoptic bronchoscopy was inserted into trachea and bronchus through LMA after the end-tidal concentration of sevoflurane reached the preset value and stabled for at least 15 min. Any visible contraction of the muscle bundle movement of trunk, limbs, head and neck was marked as positive, otherwise it was marked as negative. The EC50, EC95 and 95% confidence interval （CI） of sevoflurane were calculated. Results Totally 22 patients were enrolled in this study. The EC50 of sevoflurane was 2.30% （95% CI： 2. 08%-2. 46% ） and EC95 was 2.56% （95% CI： 2. 42%- 3.74% ） combined with remifentanil in inhibiting insertion response of fiberoptic bronchoscopy. Conclusion The ECs0 and EC95 of sevoflurane in inhibiting insertion response of fiberoptic bronchoscopy are 2. 30% and 2.56% combined with remifentanil in children.

关 键 词：纤维支气管镜 瑞芬太尼 七氟烷 小儿 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]