序贯法研究顺式阿曲库铵在短小全麻手术喉罩置入满意时的半数有效剂量  

The median effective dose of cisatracurium in laryngeal mask placement during short general anesthesia with Dixon’s Up-and-Down method

作　　者：黄珂 王小华[1] 常慧 薛纪秀[1] Huang Ke;Wang Xiaohua;Chang Hui;Xue Jixiu(Department of Anesthesiology and Operating Theater, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院麻醉手术科

出　　处：《北京医学》2019年第8期712-714,719,共4页Beijing Medical Journal

摘　　要：目的用序贯法研究顺式阿曲库铵在短小全麻手术喉罩置入满意时的半数有效剂量(median effective dose,ED50)。方法选择2018年7~9月首都医科大学宣武医院喉罩全麻下行泌尿外科短小择期手术患者18例,ASA分级Ⅰ~Ⅱ级,年龄18~65岁,BMI 18.5~30 kg/m^2。麻醉诱导依次给予舒芬太尼、依托咪酯和顺式阿曲库铵。顺式阿曲库铵注射完毕后3 min置入喉罩,同时评估喉罩置入条件。顺式阿曲库铵预设剂量按照序贯法设计:首轮初次预设剂量为0.15 mg/kg,相邻剂量公比为1.5(将剂量按等比数列设计,以便获得等间隔的对数剂量)。若喉罩置入条件满意,则下一例患者降低一级剂量;若喉罩置入条件不满意,则下一例患者升高一级剂量。从第1例不满意的病例开始计入观察单位数,"不满意-满意"出现7个交换点,试验结束。计算喉罩置入满意时顺式阿曲库铵的ED50和95%CI。结果喉罩置入满意时顺式阿曲库铵的ED50为0.026 mg/kg(95%CI:0.024~0.030 mg/kg)。结论顺式阿曲库铵复合舒芬太尼和依托咪酯诱导喉罩置入满意时的ED50为0.026 mg/kg(95%CI:0.024~0.030 mg/kg)。Objective To determine the median effective dose(ED50) of cisatracurium when laryngeal mask is satisfactorily implanted with Dixon’s Up-and-Down method. Methods Eighteen patients of ASAⅠ~Ⅱ, aged 18~65 years, BMI18.5~25.0 kg/m^2, scheduled to accept short urological surgery under general anesthesia with laryngeal mask were enrolled in this study. All the patients were induced with sufentanil, etomidate and cisatracurium. Three min after cisatracurium was injected, laryngeal mask implantation was performed. Meanwhile, the conditions of laryngeal mask implantation were observed.The dose of cisatracurium was designed according to the equal ratio series with the common ratio as 1.5, and the initial dose is0.15 mg/kg. If the implantation condition was satisfactory, the next patient received a lower dose of cisatracurium, and if the condition was unsatisfactory, the next patient received a higher dose of cisatracurium. The observation was stopped when there were seven exchange points. At the end of the experiment, ED50 and its 95% CI were calculated according to the formula of sequential method. Results ED50 of cisatracurium when the laryngeal mask was implanted satisfactorily was 0.026 mg/kg(95%CI:0.024~0.030 mg/kg). Conclusions ED50 of cisatracurium is 0.026 mg/kg(95% CI:0.024~0.030 mg/kg) when the laryngeal mask is implanted satisfactorily.

关 键 词：顺式阿曲库铵 喉罩 序贯法 半数有效剂量 

分 类 号：R614[医药卫生—麻醉学]