丙泊酚复合小剂量舒芬太尼用于宫腔镜诊治术麻醉的半数有效剂量  

Median effective dose of propofol combined with low dose sufentanil for intravenous anesthesia in hysteroscopic surgery

作　　者：俞瑾 宋云[1] 刘春[1] 李有长[1] 赵娜[1] 向波[1] YU Jin;SONG Yun;LIU Chun;LI Youchang;ZHAO Na;XIANG Bo(Department of Anesthesiology,Chongqing Health Center for Women and Children,Chongqing,401147)

机构地区：[1]重庆市妇幼保健院麻醉科,重庆401147

出　　处：《中国药物依赖性杂志》2020年第4期305-309,共5页Chinese Journal of Drug Dependence

基　　金：国家自然科学基金地区科学基金(31760327)。

摘　　要：目的:明确丙泊酚复合小剂量舒芬太尼用于宫腔镜诊治术静脉麻醉时的半数有效剂量(ED50)。方法:纳入择期在静脉麻醉下实施宫腔镜诊治术的女性患者86例,年龄21~50 a,ASAⅠ或Ⅱ级,手术操作开始前10 min给予小剂量舒芬太尼0.2μg·kg^-1,然后实施丙泊酚静脉麻醉。采用Dixon序贯法,丙泊酚初始剂量设定为2 mg·kg^-1,梯度为0.1 mg·kg^-1,若不能满足窥器、宫腔镜置入或5 min内有阳性反应,则下一例患者增加1个梯度;如可以满足检查需要并且无阳性反应,则下一例患者降低1个梯度。当出现7个拐点时研究结束。采用Probit法(概率单位回归)计算丙泊酚的ED50、ED95及其95%可信区间(95%CI)。记录患者手术时间、苏醒时间与给药后呼吸抑制的发生情况。结果:丙泊酚复合小剂量舒芬太尼0.2μg·kg^-1用于宫腔镜诊治术静脉麻醉时的ED50为1.667 mg·kg^-1(95%CI 1.586~1.736 mg·kg^-1),ED95为1.825 mg·kg^-1(95%CI 1.750~2.217 mg·kg^-1)。患者宫腔镜操作时间为10.29±4.77 min,苏醒时间为6.81±2.04 min。给药后共有20例(23.25%)发生呼吸抑制。结论:妇科宫腔镜诊治术静脉麻醉中复合小剂量舒芬太尼时,单次给予丙泊酚的ED50为1.667 mg·kg^-1,ED95为1.825mg·kg^-1。Objective:To confirm the median effective dose(ED50) of propofol combined with low dose sufentanil for intravenous anesthesia in hysteroscopy. Methods:Eighty six female patients undergoing hysteroscopic surgery under selective intravenous anesthesia, aged 21-50 years, ASA physical status I or II, were selected for this trial, propofol was administered with low dose sufentanil 0.2 μg·kg^-1 in intravenous anesthesia. The initial dose of propofol was set at 2 mg·kg^-1 and the gradient was 0.1 mg·kg^-1 by Dixon sequential method. If positive reaction was found within 5 minutes, the next patient increased by 1 gradient, and if no positive reaction was found, the next patient decreased by 1 gradient. The experiment ends when seven inflection points obtained. The ED50, ED95 and 95% confidence intervals(CI) of propofol were calculated by Probit method(probability unit regression). The duration of operation, the time of recovery and the incidence of respiratory depression were recorded. Results:A total of 86 patients were enrolled and conducted the sequential experiment. The ED50 of propofol combined with low dose sufentanil(0.2 μg·kg^-1) was 1.667 mg·kg^-1(95% CI 1.586-1.736 mg·kg^-1) and 1.825 mg·kg^-1(95% CI 1.750-2.217 mg·kg^-1), respectively. The operation duration is 10.29±4.77 min and recovery time is 6.81±2.04 min. The inccidence of respiratory depression is 23.25%(20/86). Conclusion:The ED50 and ED95 of propofol were 1.667 mg·kg^-1 and 1.825 mg·kg^-1 respectively when combined with low-dose sufentanil in intravenous anesthesia for gynecological hysteroscopy.

关 键 词：丙泊酚 舒芬太尼 静脉麻醉 腔镜 半数有效剂量 

分 类 号：R451[医药卫生—治疗学]