复合丙泊酚麻醉时纳布啡抑制无痛胃镜检查老年患者体动反应的半数有效剂量  

Half Effective Dose of Nalbuphine Inhibiting Body Motion Response in Elderly Patients Undergoing Painless Gastroscopy During Anesthesia with Propofol

作　　者：罗敏[1] 杨川[2] 王茜[1] 雷宇[1] Liio Min;Yang Chuan;Wang Qian(Department of Anesthesiology,Guangyuan Central Hospital,Guangyuan,Sichuan 628000;Department of Anesthesiology.Second People's Hospital of Guangyuan City,Guangyuan,Sichuan 628017,China)

机构地区：[1]广元市中心医院麻醉科,四川广元628000 [2]广元市第二人民医院麻醉科,四川广元628017

出　　处：《四川医学》2019年第12期1193-1195,共3页Sichuan Medical Journal

基　　金：四川省卫生计生委课题(编号:18PJ184);广元市指导性科技计划项目(编号:2018ZCZDYF023,2018ZCZDYF031)

摘　　要：目的确定复合丙泊酚麻醉时纳布啡抑制无痛胃镜检查老年患者体动反应的半数有效剂量(ED50)。方法选择2018年10月至12月在广元市中心医院行无痛胃镜检查的老年患者,性别不限,年龄65~83岁,体质指数(BMI)18~25 kg/m2,美国麻醉医师协会(ASA)分级Ⅱ级或Ⅲ级。采用序贯法进行试验。纳布啡初始剂量为0.1mg/kg,静脉注射完毕3 min后推注丙泊酚1~1.5mg/kg,待睫毛反射消失后行胃镜检查。发生体动反应时,追加丙泊酚0.5mg/kg,同时下1例患者纳布啡用量增加1个剂量梯度,如顺利完成胃镜检查则在下1例患者降低1个剂量梯度。两相邻剂量的差值0.01mg/kg。记录术中体动反应和呼吸暂停等并发症的发生情况。采用直线回归Probit法计算纳布啡抑制体动反应的ED50及其95%的可信区间。结果复合丙泊酚时,纳布啡拟制老年患者胃镜检查时发生体动反应的ED50及其95%的可信区间为0.073(0.067~0.080)mg/kg。结论复合丙泊酚时,纳布啡拟制老年患者胃镜检查时发生体动反应的ED50为0.073 mg/kg。Objective To determine half effective dose of nalbuphine inhibiting body motion response in elderly patients undergoing painless gastroscopy during anesthesia with propofol.Methods Elderly patientswho underwent painless gastroscopy at Guangyuan Central Hospital from October to December 2018,regardless of gender,aged 65-83 years,with body mass index(BMI)18-25 kg/m2,and with American Society of Anesthesiologists(ASA)GradeⅡorⅢ.The study was carried out using the sequential method.The initial dose of nalbuphine was 0.1 mg/kg and after 3 minutes of intravenous injection of nalbuphine,propofol was administered at a dose of 1 to 1.5 mg/kg.After the eyelash reflex disappeared,gastroscopy was performed.When body motion response occurred,propofol was added at a dose of 0.5 mg/kg,anddose of nalbuphine was increased by one dose gradient in the next patient.If the gastroscopy was successfully completed,one dose gradient of nalbuphine was lowered in the next patient.The difference between the two adjacent doses is 0.01 mg/kg.The incidence of complications such asbody motion response and apnea during surgery was recorded.The linear regression Probit method was used to calculate the ED50 of nalbuphine inhibiting body motion response and its 95%confidence interval.Results In combination with propofol,the ED50 of nalbuphine inhibiting body motion response in elderly patients undergoing gastroscopy and its 95%confidence interval were 0.073(0.067-0.080)mg/kg.Conclusion In combination with propofol,ED50 of nalbuphine inhibiting body motion response in elderly patients undergoing gastroscopy was 0.073 mg/kg.

关 键 词：纳布啡 二异丙酚 胃镜检查 剂量效应关系 药物 老年人 

分 类 号：R57[医药卫生—消化系统]