羟考酮复合依托咪酯-罗库溴铵全麻诱导时抑制气管插管反应的量效关系  

Dose-effect relationship of oxycodone inhibiting responses to endotracheal intubation with combination of etomidate-rocuronium during induction of general anesthesia

作　　者：陈鹭[1] 林颖仡 俞建钧 李敏 林财珠[1] 林志坚 Chen Lu;Lin Yingyi;Yu Jianjun;Li Min;Lin Caizhu;Lin Zhijian(Department of Anesthesiology,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Department of Anesthesiology and Perioperative Medicine,900 Hospital of the Joint Logistics Team of the PLA,Fuzhou 350025,China;Department of Anesthesiology,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China)

机构地区：[1]福建医科大学附属第一医院麻醉科,福州350005 [2]解放军联勤保障部队第九〇〇医院麻醉与围术期医学科,福州350025 [3]福建医科大学附属漳州市医院麻醉科,363000

出　　处：《中华麻醉学杂志》2021年第9期1112-1115,共4页Chinese Journal of Anesthesiology

摘　　要：目的确定羟考酮复合依托咪酯-罗库溴铵全麻诱导时抑制气管插管反应的量效关系。方法拟行气管插管全身麻醉的择期手术患者120例,性别不限,年龄20~63岁,BMI 18.0~25.2 kg/m^(2),ASA分级Ⅰ或Ⅱ级。采用随机数字表法分为4组(n=30):分别缓慢静脉注射羟考酮0.15 mg/kg(O_(0.15)组)、0.23 mg/kg(O_(0.23)组)、0.34 mg/kg(O_(0.34)组)或0.51 mg/kg(O_(0.51)组),3 min后依次静脉注射依托咪酯0.3 mg/kg和罗库溴铵0.8 mg/kg,2~3 min后采用Macintosh喉镜行气管插管术。记录气管插管前即刻HR、SBP和DBP,气管插管后3 min内HR、SBP和DBP峰水平;气管插管后SBP和(或)HR升高且超过插管前水平的30%定义为气管插管反应,并记录麻醉诱导期间不良事件的发生情况。结果O0.15组、O0.23组、O0.34组和O0.51组气管插管反应发生率分别为97%、73%、27%和3%。羟考酮抑制气管插管反应的ED_(50)(95%可信区间)为0.259(0.230~0.292)mg/kg,ED_(95)(95%可信区间)为0.387(0.358~0.420)mg/kg。O0.51组仅低血压发生率(26%)显著高于其余3组(P<0.05)。结论复合依托咪酯-罗库溴铵全麻诱导时,羟考酮抑制Macintosh喉镜下气管插管反应的ED_(50)和ED_(95)分别为0.259和0.387 mg/kg,推荐其适宜剂量0.51 mg/kg。Objective To determine the dose-effect relationship of oxycodone inhibiting responses to endotracheal intubation with combination of etomidate-rocuronium during induction of general anesthesia.Methods A total of 120 patients,aged 20-63 yr,with body mass index of 18.0-25.2 kg/m^(2),of American Society of Anesthesiologists physical statusⅠorⅡ,scheduled for elective surgery under general anesthesia with tracheal intubation,were divided into 4 groups(n=30 each)using a random number table method:group O0.15,group O0.23,group O0.34 and group O0.51.In O0.15,O0.23,O0.34 and O0.51 groups,oxycodone 0.15 mg/kg,0.23 mg/kg,0.34 mg/kg and 0.51 mg/kg were injected intravenously,respectively,3 min later etomidate 0.3 mg/kg and rocuronium 0.8 mg/kg were intravenously injected in turn,and tracheal intubation was performed using Macintosh laryngoscope.Heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure immediately before intubation and the peak levels of HR,BP and diastolic blood pressure within 3 min after intubation were recorded.The response to endotracheal intubation was defined by the SBP and(or)HR having increased by more than 30%following intubation.The occurrence of adverse events during induction of anesthesia were recorded.Results The rate of response to endotracheal intubation was 97%,73%,27%,and 3%in O_(0.15),O_(0.23),O_(0.34) and O_(0.51) groups,respectively.The median effective dose(ED_(50))(95%confidence interval)of oxycodone inhibiting responses to endotracheal intubation was 0.259(0.230-0.292)mg/kg,and the 95%effective dose(ED_(95))(95%confidence interval)was 0.387(0.358-0.420)mg/kg.Only the incidence of hypotension(27%)was significantly higher in group O0.51 than in the other 3 groups(P<0.05).Conclusion With combination with etomidate-rocuronium,the ED_(50) and ED_(95) of oxycodone inhibiting responses to endotracheal intubation performed using Macintosh laryngoscope during induction of general anesthesia are 0.259 mg/kg and 0.387 mg/kg,respectively,and the optimum dose 0.51 mg/kg is recomm

关 键 词：羟可酮 依托咪酯 雄甾烷醇类 剂量效应关系 药物 插管法 气管内 应激 

分 类 号：R614.2[医药卫生—麻醉学]