Schnider模型用于全麻剖宫产诱导时丙泊酚的效应室靶浓度  

Effect-site concentration of propofol in cesarean section under general anesthesia using Schnider model

作　　者：聂晶晶 黄绍强 孙申 NIE Jing-jing;HUANGShao-qiang;SUN Shen(Department of Anesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai200080, China)

机构地区：[1]复旦大学附属妇产科医院麻醉科,上海200080

出　　处：《中国临床医学》2018年第6期910-914,共5页Chinese Journal of Clinical Medicine

基　　金：上海卫生和计划生育委员会青年基金(201344196)~~

摘　　要：目的:探讨在Schnider模型下进行剖宫产全麻诱导时,能提供足够麻醉深度的丙泊酚效应室靶浓度(effect-site propofol concentration,ECe)。方法:选择72例ASAⅠ～Ⅱ级择期全麻行接受剖宫产的产妇,按照不同的丙泊酚ECe(4.0、4.5、5.0、5.5、6.0、6.5μg/mL)分为6组,每组12例。采用Schnider模型进行丙泊酚靶控输注,意识消失后1min,脑电双频指数(BIS)值<60且丙泊酚达到ECe时,行气管插管。采用Probit回归分析计算产妇全麻诱导时的丙泊酚ECe50和ECe95。记录产妇平均动脉压(MAP)、心率(HR)、BIS、Apgar评分、新生儿脐动脉血气分析结果和分娩时间。结果:各组间产妇的一般情况差异无统计学意义。产妇全麻诱导的丙泊酚ECe50和ECe95分别为5.14μg/mL(95%CI 4.90～5.38)和6.07μg/mL(95%CI 5.72～6.96)。各组间产妇MAP、HR,新生儿Apgar评分,新生儿脐动脉血气结果和娩出时间差异无统计学意义。结论:Schnider模型下产妇进行择期剖宫产全麻诱导时,丙泊酚的ECe50和ECe95分别为5.14μg/mL和6.07μg/mL。Objective:To determine the target propofol effect-site concentration(ECe)that is needed for adequate depth of anesthesia in cesarean section under general anesthesia using the Schnider model.Methods:Seventy-two ASAⅠ-Ⅱparturients undergoing elective cesarean section under general anesthesia were selected.Parturients were allocated into six groups(twelve patients in each)and received propofol withdifferent ECe(4.0、4.5、5.0、5.5、6.0、6.5μg/mL).Propofol target-controlled infusion was performed using the Schnider model.After loss of consciousness,tracheal intubation was performed1minute later when the bispectral index(BIS)value was<60and target propofol ECe had been reached.Probit regression analysis was performed to calculate the ECe50and ECe95of propofol for the induction of general anesthesia in parturients.Mean arterial pressure(MAP),heart rate(HR),BIS,Apgar score,neonatal umbilical artery blood gas,and delivery time were obtained and recorded.Results:The general characteristics of Parturients among6groups were not significantly different.The calculated propofol ECe50and the ECe95were5.14μg/mL(95%CI4.90-5.38)and6.07μg/mL(95%CI5.72-6.96)respectively for the induction of general anesthesia in parturients.There were no significantly differences in MAP,HR,Apgar score,neonatal umbilical artery blood gas,and delivery time among different6groups.Conclusions:The ECe50and ECe95were5.14μg/mL and6.07μg/mL respectively for the induction of general anesthesia in parturients undergoing elective cesarean section when using the Schnider model.

关 键 词：产妇 丙泊酚 效应室靶浓度 全身麻醉 剖宫产 

分 类 号：R614.24[医药卫生—麻醉学]