酒石酸布托啡诺对老年患者丙泊酚靶控静脉滴注时EC50的影响  

Effects of Butorphanol on the Medium Effective Concentration(EC50)of Propofol Target Controlled Infusion in Senile Patients

作　　者：韦凯斌 马家慧 吴立新[1] 林宏凯[1] 王汉欢 Wei Kaibin;Ma Jiahui;Wu Lixin(Department of 2nd Anesthesiology,Zhongshan People′s Hospital,Guangdong 528403,China)

机构地区：[1]中山市人民医院麻醉二科,528403

出　　处：《医学研究杂志》2021年第10期97-101,共5页Journal of Medical Research

基　　金：广东省中山市卫生健康局医学科研项目(2020J044)。

摘　　要：目的探究酒石酸布托啡诺对丙泊酚靶控静脉滴注应用于老年患者全身麻醉时半数有效浓度(medium effective concentration,EC50)和血流动力学的影响。方法拟气管插管全身麻醉下行手术的老年患者(60~75岁)120例,按1∶1∶1∶1随机分为对照组和实验组。实验组(5B组、10B组和15B组)分别静脉泵注5、10和15μg/kg负荷剂量的布托啡诺,对照组予等容量的0.9%氯化钠溶液。丙泊酚的初始作用效应室靶点浓度为4μg/ml,应用Dixon上下序贯方法调整靶浓度,以0.5mg/ml间隔调整浓度,当达到设定浓度时,用OAA/S评分判断意识是否消失并记录。用Probit概率分析确定丙泊酚的EC50。记录给药前T1、给予布托啡诺10min后T2及意识消失时T3收缩期动脉压、心率、血氧饱和度和阿托品或麻黄素应用情况。结果布托啡诺3个处理组达到意识消失的丙泊酚浓度EC50最低的是15B组,15B显著低于5B组和对照组,但是与10B组比较差异无统计学意义。15B组在T3时点的SpO_(2)较T1时点显著下降,其余3组无明显改变。各组间阿托品(0~10%)和麻黄素(13.3%~20%)的应用情况差异无统计学意义。结论布托啡诺能显著降低丙泊酚用于老年人全身麻醉的靶控静脉滴注浓度,与10μg/kg布托啡诺联合使用时,丙泊酚靶控静脉滴注的EC50与应用15μg/kg时比较,差异无统计学意义,而血氧饱和度降低的风险显著降低。Objective To investigate the effect of butorphanol on the medium effective concentration(EC50)of propofol for successfμl laryngeal mask insertion in senile patients.Methods Totally 120 senile patients aged between 60 to 75 years who had abdominal surgery under general anesthesia were randomly divided into control group and 3 treatment groups.Patients in treatment groups(5B,10B and 15B)received intravenous injection of 5,10 and 15μg/kg butorphanol,respectively,while patients in control group received saline of equal amount.The initial target concentration of propofol was 4μg/ml and the concentration as adjusted with the Dixon sequential method at 0.5mg/ml interval.OAA/S was used to note if the conscious was lost and the EC50 of propofol was determined with Probit analysis.The systolic blood pressure(SBP),heart rate(HR),oxygen saturation(SpO_(2))and the application of atropine or ephedrine.Results The lowest EC50 of propofol concentration in the three treatment groups of butorphanol was achieved in the 15B group,which was significantly lower than the 5B group and the control group,but there was no significant difference from the 10B group.The SpO 2 of the 15B group at T3 was significantly lower than that at T1,and there was no significant change in the other three groups.However,there was no significant difference in the application of atropine(0-10%)and ephedrine(13.3%-20%)between the groups.Conclusion Butorphanol can significantly reduce the target-controlled infusion concentration of propofol use for general anesthesia in the in senile patients.Combined with 10μg/kg butorphanol.The EC50 of propofol TCI was not significantly different from that of 15μg/kg,and with the lower risk of decreased blood oxygen saturation.

关 键 词：酒石酸布托啡诺 丙泊酚 老年 半数有效浓度 

分 类 号：R614.2[医药卫生—麻醉学]