不同剂量羟考酮对插入喉罩的丙泊酚Cp50的影响  

Effects of different dosage of oxycodone on propofol Cp50 under general anesthesia with propofol TCI

作　　者：谭志斌 谢宗源 杨超杰 路艳红 TAN Zhibin;XIE Zongyuan;YANG Chaojie;LU Yanhong(North China University of Science and Technology Affili.ated Hospital,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院麻醉科,唐山063000

出　　处：《实用医学杂志》2018年第13期2232-2235,共4页The Journal of Practical Medicine

基　　金：河北省2017年度医学科学研究重点课题(编号:20170906)

摘　　要：目的比较不同剂量羟考酮对全麻诱导期间插入喉罩时丙泊酚Cp50的影响。方法共纳入ASA分级Ⅰ-Ⅱ的择期手术患者107例,按照随机原则分为5组:丙泊酚(P组);丙泊酚+瑞芬太尼(血浆靶浓度为2 ng/m L)组(R组);丙泊酚+0.1 mg/kg羟考酮组(O_1组);丙泊酚+0.15 mg/kg羟考酮组(O_2组);丙泊酚+0.2 mg/kg羟考酮组(O_3组);各组均靶控输注丙泊酚。采用改良后的Dixon上下交叉序贯法,根据插入喉罩时患者是否发生体动增加或减少下一个患者丙泊酚(0.5μg/m L)血浆靶控浓度。记录麻醉诱导前(T_0)、插入喉罩前1 min(T_1)、插入喉罩时(T_2)、插入后1 min(T_3)、3 min(T_4)时的心率、平均动脉压及BIS值。根据平衡点后的丙泊酚浓度值,计算出每组丙泊酚浓度,即为每组插入喉罩时丙泊酚Cp50值。结果五组患者的年龄、体质指数、性别构成比、麻醉诱导前的心率、平均动脉压、BIS值均无明显差别(P>0.05)。五组患者插入喉罩前后的心率、平均动脉压以及BIS值同诱导前相比,有着明显的下降(P<0.05)。P组、R组、O_1组、O_2组及O_3组及丙泊酚Cp50分别(4.92±0.30)μg/m L、(2.54±0.36)μg/m L、(3.31±0.34)μg/m L、(2.58±0.30)μg/m L、(2.04±0.37)μg/m L。与P组相比,R组、O_1组、O_2组和O_3组的丙泊酚Cp50明显下降(P<0.05),O_1组、O_2组及O_3组的丙泊酚Cp50呈进行性下降(P<0.05),O_2组和R组的丙泊酚Cp50未见明显差异(P>0.05)。结论羟考酮可降低成功插入喉罩时丙泊酚Cp50,且与剂量相关。0.15 mg/kg羟考酮与瑞芬太尼2 ng/m L血浆靶控输注效果相当。Objective To investigate the effects of oxycodone on propofol Cp50 under general anesthesia with propofol TCI.Methods One hundred and seven ASA I^II patients were randomly divided into five groups:propofol group(P gruop n=21):threated with propofol alone;remifentanil group(R group,n=20):propofol plus remifentanil(target plasma concentration of 0.2 ng/mL);oxycodone group:propofol plus oxycodone 0.1 mg/kg(O1,n=18),0.15 mg/kg(O2,n=24)and 0.2 mg/kg(O3,n=20).According to the patient′s body movement in response to increase or decrease 0.5μg/mL of propofol Cp.HR,MAP and BIS before induction(T0),before insert of laryngeal mask(T1),at insert of laryngeal mask(T2),1 min(T3)and 3 min(T4)after insert of laryngeal mask.According to the concentration of propofol after reaching the equilibrium point,propofol Cp50 in each group was calculated using a modification of Dixon--s up-and-down method.Results No differences were found in the demographic data among the five groups.Cp50 of propofol was 4.92±0.30μg/mL,2.54±0.36μg/mL,3.31±0.34μg/mL,2.58±0.30μg/mL and 2.04±0.37μg/mL in P,R,O1,O2 and O3 group,respectively.Cp50 in R,O1,O2 and O3 group was significantly lower than that in P group(P<0.05).Cp50 in O2 group was similar with R group(P>0.05).Conclusion Our study shown that oxycodone reduced propofol Cp50 during successfully insert-ed the laryngeal mask under general anesthesia,the effect of oxycodone 0.15 mg/kg to be quite with remifentanil 0.2 ng/mL.

关 键 词：丙泊酚 羟考酮 瑞芬太尼 丙泊酚Cp50 靶控输注 

分 类 号：R614[医药卫生—麻醉学]