复合阿芬太尼时丙泊酚或环泊酚抑制人工流产术中体动反应的半数有效剂量  

Median effective dose of propofol or cyclopofol combined with alfentanil in inhibiting body movement response during induced abortion

作　　者：徐海 朱婷婷 周红梅 XU Hai;ZHU Tingting;ZHOU Hongmei(Department of Anesthesiology,the Second Hospital of Jiaxing,Jiaxing 314000,Zhejiang,China)

机构地区：[1]嘉兴市第二医院麻醉科,浙江嘉兴314000

出　　处：《中国现代医生》2024年第14期84-87,共4页China Modern Doctor

基　　金：浙江省嘉兴市科技计划项目(2022AD30027)。

摘　　要：目的探讨复合阿芬太尼时丙泊酚或环泊酚抑制人工流产术中体动反应的半数有效剂量。方法选择2021年10月-2022年4月在嘉兴市第二医院妇科手术中心行择期无痛人工流产术的患者,年龄18~35岁,体质量指数(body mass index,BMI)18~28kg/m^(2),美国麻醉医师协会(American Society of Anesthesologists,ASA)分级为Ⅰ或Ⅱ级,胎儿年龄<10周,初次妊娠或无经阴道分娩史。采用随机数字表法将患者分为2组:丙泊酚组(P组)和环泊酚组(C组)。麻醉诱导时静脉注射阿芬太尼后给予改良序贯法设定剂量的丙泊酚或环泊酚,若术中患者出现肢体不自主运动并影响术者手术操作且需追加麻醉药物即判定为阳性反应,并且静脉追加丙泊酚或环泊酚0.5mg/kg或0.1mg/kg,下一例患者丙泊酚或环泊酚增加一个剂量梯度。反之则下一例患者丙泊酚或环泊酚减少一个剂量梯度,相邻患者的丙泊酚或环泊酚剂量梯度分别为0.5mg/kg和0.1mg/kg。采用Probit回归分析法计算丙泊酚和环泊酚的50%有效剂量(median effective dose,ED_(50))、95%有效剂量(95% effective dose,ED_(95))及相应的置信区间(confidence interval,CI)。结果P组丙泊酚抑制人工流产术中体动反应的ED_(50)(95%CI)为1.815(1.315~2.319)mg/kg,ED_(95)(95%CI)为2.901(2.368~6.447)mg/kg;C组环泊酚抑制体动反应的ED_(50)(95%CI)为0.381(0.279~0.484)mg/kg,ED_(95)(95%CI)为0.613(0.501~1.344)mg/kg,两者对应的等效比值为4.76(4.71~4.79)。结论复合阿芬太尼时环泊酚抑制人工流产术中体动反应的效价大于丙泊酚。Objective To explore the median effective dose of propofol or cyclopofol combined with alfentanil in inhibiting body movement response during induced abortion.Methods From October 2021 to April 2022,patients aged 18-35 years,body mass index(BMI)18-28 kg/m^(2),American Society of Anesthesologists(ASA)Ⅰ or Ⅱ,fetal age<10 weeks,first pregnancy or no history of vaginal delivery were selected for elective painless induced abortion in Gynecological Surgery Center of the Second Hospital of Jiaxing.Patients were divided into 2 groups using a random number table method:propofol group(group P)and cyclopofol group(group C).During anesthesia induction,intravenous injection of alfentanil was followed by administration of propofol or cyclopofol with a dose set by the modified sequential method.If the patient had involuntary limb movement during surgery and affected the operation of the operator and needed additional anesthetic drugs,it was judged as a positive reaction,and intravenous propofol or cyclopofol 0.5mg/kg or 0.1mg/kg was added,and the next patient’s propofol or cyclopofol was increased by a dose gradient.Conversely,the next patient was given a dose gradient of 0.5mg/kg propofol or 0.1mg/kg cyclopofol,respectively.Probit regression analysis was used to calculate the median effective dose(ED_(50)),95% effective dose(ED_(95))and corresponding confidence interval(CI)of propofol and cyclopofol.Results The ED_(50)(95%CI)and ED_(95)(95%CI)of propofol in group P were 1.815(1.315-2.319)mg/kg and 2.901(2.368-6.447)mg/kg,respectively.The ED_(50)(95%CI)and ED_(95)(95%CI)of cyclopofol in group C were 0.381(0.279-0.484)mg/kg and 0.613(0.501-1.344)mg/kg,respectively,and the equivalent ratio of the two was 4.76(4.71-4.79).Conclusion The potency of ciprofol in inhibiting movement response during induced abortion is greater than that of propofol.

关 键 词：阿芬太尼 环泊酚 人工流产术 半数有效剂量 

分 类 号：R614[医药卫生—麻醉学]