女性月经周期对丙泊酚半数有效血浆靶浓度的影响  

Effects of Menstrual Cycle on Median-Effective Target Plasma Concentration of Propofol

作　　者：张建辉 谭智进 曾友雄 李镇铭 

机构地区：[1]东莞市石排医院麻醉科,广东东莞523330

出　　处：《湖北科技学院学报（医学版）》2017年第5期378-380,共3页Journal of Hubei University of Science and Technology(Medical Sciences)

摘　　要：目的观察女性月经周期对丙泊酚半数有效血浆靶浓度的影响。方法选择全身麻醉下行腹腔镜妇科手术的20~40岁女性患者80例,根据血清孕酮浓度分为卵泡期组和黄体期组,每组40例。应用Marsh药代动力学模型,靶控输注丙泊酚进行麻醉诱导,起始血浆浓度设为3.5μg/m L,相邻靶浓度比值为1.1。计算两组患者入睡时丙泊酚半数有效血浆靶浓度(EC_(50))及置信区间。结果卵泡期组患者入睡时丙泊酚EC_(50)为4.81μg/m L,95%可信区间(4.56~5.08)μg/m L;黄体期组患者入睡时丙泊酚EC_(50)为4.19μg/m L,95%可信区间(3.87~4.54)μg/m L,与卵泡期组比较,黄体期组EC_(50)降低(P<0.01)。结论与卵泡期相比,黄体期丙泊酚麻醉诱导用量明显减少。Objective To observe the effects of menstrual cycle on median-effective target plasma con-centration of propofol. Methods Eighty patients aged 20 -40 years were scheduled for gynecological laparo- scopic surgery under general anesthesia and were divided into two groups with 40 cases in each group according to their preoperative levels of progesterone ： the follicular group and the luteal group. Propofol was administered by target controlled infusion （ TCI）. TCI system was incorporated with Marsh pharmacokinetic model. The target plasma concentration was set at 3. 5jjig/mL in the first patient. Each time, target plasma concentration was in-creased or decreased by 10% in the next patient. Median-effective target plasma concentration（ EC50 ） and 95% confidence interval of propofol causing loss consciousness were calculated. Results The EC5〇 and 9 5% confi-dence interval of propofol TCI causing loss consciousness were 4. 81（4. 5 6 - 5 .0 8 ） ｜xg/mL in the follicular group,and 4. 19（3. 87 -4. 54） jxg/mL in the luteal group. EC50 in the luteal group was significantly lower than in the follicular group（P 〈0.01）. Conclusion For female patients in the luteal phase,the induction dose nee-ded for propofol is significantly reduced compared with those in the follicular phase.

关 键 词：全身麻醉 丙泊酚 月经周期 

分 类 号：R614.2[医药卫生—麻醉学]