芬太尼对异丙酚抑制高龄患者肠镜检查体动反应半数有效血浆浓度的影响  

The Effects of Fentanyl on the EC_(50) of Propofol Inhibiting Coloscopy Induced Body Dynamic Response in Elderly Patients

作　　者：谢文钦[1] 江惠琼[2] 高文峰[3] 赵桀[1] 李顺元[1] 孙加晓[1] 

机构地区：[1]福建医科大学附属泉州市第一医院麻醉科,泉州362000 [2]福建医科大学附属泉州市第一医院心功能室,泉州362000 [3]福建医科大学附属泉州市第一医院体检中心,泉州362000

出　　处：《福建医科大学学报》2015年第3期175-177,共3页Journal of Fujian Medical University

基　　金：泉州市科学委员会资助课题(2008Z30)

摘　　要：目的探讨芬太尼对异丙酚抑制高龄患者肠镜检查体动反应半数有效血浆浓度的影响。方法择期行肠镜检查术的高龄患者90例,男性45例,女性45例,年龄(81±7)岁(75~89岁),ASAⅡ~Ⅲ级,体质量指数19~27kg/m2。采用随机数字表法,将患者分为3组(n=30),即生理盐水对照组(C组)和不同剂量芬太尼组(F0.5组、F1.0组)。采用血浆靶控输注(TCI)异丙酚,3组初始靶浓度为2.0μg/mL,达靶浓度后,C组、F0.5组、F1.0组分别静脉注射芬太尼0,0.5,1.0μg/kg(用生理盐水稀释至5mL),3min后行肠镜检查术。检查过程中如患者出现头部或四肢有目的的较大动作,则定义为肠镜检查诱发的体动反应。采用序贯法确定异丙酚血浆靶浓度,相邻浓度值差0.5μg/mL,出现体动反应者,下一例采用高一级浓度;若未出现体动反应,则采用低一级浓度。用概率单位法确定异丙酚半数有效血浆浓度(EC50)及其95%可信区间(CI)。结果 C组、F0.5组、F1.0组的EC50及其95%CI分别为3.05(2.72~3.36),2.76(2.45~3.09),2.20(1.72~2.67)μg/mL,异丙酚EC50呈递减趋势(P<0.05)。结论高龄患者行肠镜检查术时,随着复合芬太尼剂量的增加,异丙酚抑制肠镜检查术诱发的体动反应的EC50随之递减。Objective To determine the effects of fentanyl on the EC50 of propofol inhibiting coloscopy induced body dynamic response in elderly patients. Mehthods Electly coloscopy 90 patients,aged 75~89years,ASA gradeⅡorⅢ,body mass index 19~27kg/m2. The patients were randomly devided into three groups(n=30),saline control group(group C)and different doses of fentanyl group(F0.5group,F1.0group). Using plasma target-controlled(TCI)of propofol infusion for three groups,the initial target concentration was 2μg/mL. After the target concentrations of plasma and effect-site of propofol were balanced,group C,F0.5 group and F1.0 group)intravenous injection of fentanyl were 0,0.5,1.0μg/kg(diluted with saline to 5mL)respectively. 3minunes later underwent colonoscopy surgery.If the patient has the head or limbs to larger movements,is determined to body movement. Using the sequential method to determine the plasma concentration of propofol,adjacent concentration difference of0.5μg/mL;body movement occurs responders,the next one case high a concentration;if there is not movement in response,then the use of low-level concentrations of. Determined by probit propofol EC50 and its 95% confidence interval(CI). Results Group C,F0.5 group and F1.0 group propofol EC50and95%CI were 3.05(2.72~3.36),2.76(2.45~3.09)and 2.20(1.72~2.67)μg/mL.Propofol EC50 showed a decreasing trend(P<0.05). Conclusion The EC50 of propofol for fibercolonoscope examination was 3.05,2.76,2.20μg/mL respectively of the three group.

关 键 词：剂量效应关系 药物 芬太尼 二异丙酚 结肠镜检查 

分 类 号：R614[医药卫生—麻醉学]