复合依托咪酯时瑞芬太尼抑制SLIPA喉罩置入反应的EC_(50)  

EC_(50) value of remifentanil combined with etomidate for attenuating cardiovascular responses to SLIPA laryngeal mask insertion

作　　者：李雪萍[1] 翁振声[1] 刘才堂[1] 曾丽萍[2] 

机构地区：[1]中山大学附属东华医院麻醉科,广东东莞523110 [2]中山大学附属东华医院统计室,广东东莞523110

出　　处：《临床医学》2017年第4期38-40,共3页Clinical Medicine

摘　　要：目的探讨复合依托咪酯时瑞芬太尼抑制SLIPA喉罩置入反应的半数有效浓度(EC_(50))。方法择期腹腔镜手术患者26例,年龄18~62岁。瑞芬太尼的初始剂量为0.8 ng/ml,按剂量-效应序贯法调节下1例患者剂量,喉罩置入反应阴性-阳性出现7次交叉时试验结束。采用概率分析法计算瑞芬太尼抑制SLIPA喉罩置入反应的EC_(50)。结果共24例患者完成研究,瑞芬太尼抑制SLIPA喉罩置入反应的EC_(50)及其95%CI为0.572(0.349~0.746)ng/ml。患者在全身麻醉诱导期Narcotrend值均波动在40~60,喉罩置入反应出现在置入后10~20 s。无一例患者使用血管活性药物。结论瑞芬太尼抑制SLIPA喉罩置入反应的EC_(50)为0.572 ng/ml。Objective To investigate the effective concentration of remifentanil combined with etomidate at which 50% patients attenuate the cardiovascular responses to SLIPA laryngeal mask insertion. Methods Twenty-six patients were scheduled for laparoscopic surgery, aged 18 to 62. The dose of sequent patients was predetermined using a modified up- and-down method of dixon （starting at 0. 8 ng/ml and step size of 0. 2 ng/ml） based on cardiovascular responses to SLIPA laryngeal mask insertion. The positive reaction was defined that as SBP or HR was 20% higher than its basic value, or tears was reaction. The probit analysis was performed to calculated the EC50and 95% confidence interval（CI） of remifentanil to provide satisfying conditions. Results Twenty-four patients completed the research. The EC50 and 95% CI of remifentani inhibiting SLIPA laryngeal mask insertion reaction was 0. 572 （0. 349 - 0. 746） ng/ml. In the anesthesia induction period, Narcotrend values of all patients were between 40 - 60. Cardiovascular responses in the 10 - 20 s after SLIPA laryngeal mask insertion. None of the patients were treated with vasoactive drugs. Conclusion The EC50values of remifentanil combined with etomidate for attenuating cardiovascular responses to SLIPA laryngeal mask insertion was 0. 572 ng/ml.

关 键 词：瑞芬太尼 喉罩 半数有效浓度 

分 类 号：R614[医药卫生—麻醉学]