复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的半数有效血浆靶浓度  

Median effective plasma concentration of propofol inhibiting body movement when combined with butorphanol in patients undergoing hysteroscopic surgery

作　　者：杨沁岩 黄立[1] 石岚[1] 欧媛媛 黎国媛 黄成勇 YANG Qinyan;HUANG Li;SHI Lan;OU Yuanyuan;LI Guoyuan;HUANG Chengyong(Deparrment of Anesthesiology,Chongqing Seventh People's Hospital,Chongqing 400054,China)

机构地区：[1]重庆市第七人民医院麻醉科,重庆400054

出　　处：《中国临床药理学与治疗学》2020年第9期1033-1037,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：重庆市科卫联合医学科研项目(2019QNXM009);重庆市巴南区科技计划项目(2019SHSY524)。

摘　　要：目的:确定复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的半数有效血浆靶浓度(Cp 50)。方法:选择21例拟行宫腔镜手术患者,年龄20~55岁,ASAⅠ或Ⅱ级。麻醉采用非插管静脉麻醉,麻醉诱导采用靶控输注丙泊酚,当血浆靶浓度和效应室靶浓度达平衡时方可宫腔镜手术操作,手术操作前5 min静脉缓慢注射酒石酸布托啡诺20μg/kg。监测麻醉不同时点的麻醉深度及不良反应。采用序贯法确定丙泊酚血浆靶浓度(Cp),第1例患者丙泊酚血浆Cp设为2.5μg/mL,手术中发生体动时为阳性,下一例采用高一级浓度,否则采用低一级浓度,浓度的比值为1∶1,根据结果将患者分为阳性和阴性组。用序贯法公式计算复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的Cp 50及其95%CI。结果:复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的Cp 50及其95%CI为2.23(2.12~2.34)μg/mL。所有患者均未发生严重不良反应。结论:复合20μg/kg布托啡诺时丙泊酚抑制宫腔镜手术患者体动的Cp 50为2.23μg/mL,为宫腔镜手术麻醉安全用药提供参考。AIM:To determine the median effective plasma concentration(Cp 50)of propofol inhibiting body movement when combined with butorphanol in patients undergoing hysteroscopic surgery.METHODS:Twenty-one patients scheduled for elective hysteroscopic surgery under non-intubated intravenous anesthesia,age 20-55 years old,ASA physical statusⅠorⅡ,were enrolled in this study,and anesthesia was induced by target-controlled infusion of propofol.Hysteroscopy was performed only when the plasma concentration and the concentration of the effector chamber were balanced.Butorphanol 20μg/kg was injected intravenously at 5 min before surgery.The depth of anesthesia and adverse reactions during anesthesia was monitored.The plasma target concentration(Cp)of propofol was determined by up-and-down method,the first patient was 2.5μg/mL,each time Cp increased/decreased by 10%in the next patient depending on whether or not body movement occurred.The patients were divided into positive and negative groups according to the results.The Cp 50 and 95%confidence inlerval(CI)of propofol inhibiting body movement were calculated by up-and-down formula when combined with butorphanol in patients undergoing hysteroscopic surgery.RESULTS:The Cp 50(95%CI)of propofol required to inhibit body movement was 2.23(2.12-2.34)μg/mL when combined with butorphanol in patients undergoing hysteroscopic surgery.None of the patients had serious adverse reactions.CONCLUSION:The Cp 50 of propofol required to inhibit body movement is 2.23μg/mL when combined with 20μg/kg butorphanol in patients undergoing hysteroscopic surgery.It provides a reference for safe dosage of anesthesia in hysteroscopic surgery.

关 键 词：丙泊酚 布托啡诺 宫腔镜手术 半数有效血浆靶浓度 

分 类 号：R614[医药卫生—麻醉学] R969[医药卫生—外科学]