环泊酚诱导行腹部手术老年患者意识消失的半数有效量评估  

Exploration of the median effective dose of ciprofol-induced loss of consciousness in geriatric patients undergoing abdominal surgery

作　　者：MUHOZA Bertrand-Geoffrey 梁增辉 谢艳乐 陈书涵 吴有杰 袁静静[1] MUHOZA Bertrand-Geoffrey;LIANG Zenghui;XIE Yanle;CHEN Shuhan;WU Youjie;YUAN Jingjing(Department of Anesthesiology,Pain and Perioperative Medicine,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院麻醉与围手术期及疼痛医学部,郑州450052

出　　处：《郑州大学学报（医学版）》2024年第4期488-491,共4页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:评估环泊酚诱导行腹部手术老年患者意识消失的半数有效量(ED 50)。方法:选取2023年4至7月在本院择期全凭静脉麻醉下行腹部手术的老年患者,采用Dixon序贯法纳入研究,初始环泊酚诱导剂量为0.3 mg/kg,相邻患者环泊酚诱导剂量梯度差值为0.03 mg/kg,如果患者意识消失则下一例患者降低1个梯度,反之则升高1个梯度,待出现7个交叉拐点则终止该研究。采用Probit概率法计算环泊酚ED 50以及95%CI。记录开始给药至给药后3 min内患者的心率(HR)、脉搏氧饱和度(SpO 2)、平均动脉压(MAP)、脑电双谱指数(BIS)、改良警觉镇静评分(MOAA/S),每30 s记录一次数据;记录给药后患者低血压、心动过缓、呼吸抑制、注射痛情况和诱导期间环泊酚总剂量。结果:共纳入26例,年龄65~78岁,BMI 18.0~28.0 kg/m 2,ASA分级Ⅱ~Ⅲ级。环泊酚诱导致老年患者意识消失的ED 50(95%CI)为0.267(0.250~0.284)mg/kg。与麻醉诱导即刻比较,给药后30、60、90、120、150、180 s时的MOAA/S评分、BIS、MAP明显下降(P<0.05),HR无明显变化;患者均未发生注射痛、低血压和需要处理的心动过缓。结论:环泊酚诱导行腹部手术老年患者意识消失的ED 50(95%CI)为0.267(0.250~0.284)mg/kg。Aim:To evaluate the median effective dose of ciprofol-induced loss of consciousness in geriatric patients undergoing abdominal surgery.Methods:The geriatric patients undergoing abdominal surgery from April to July 2023 were chosen,and enrolled the study by Dixon sequential method.The initial dose of ciprofol was 0.3 mg/kg,and the gradient difference of ciprofol dose of the successive patients was 0.03 mg/kg.If a patient experienced loss of consciousness,the next patient′s dose was decreased by 0.03 mg/kg;otherwise,increased by 0.03 mg/kg.The study was terminated when 7 crossover points occurred.The Probit probability method was used to calculate the median effective dose(ED 50)(95%CI)of ciprofol.HR,SpO 2,MAP,BIS,and MOAA/S values were recorded every 30 seconds from the start of drug administration to 3 minutes after administration.The total dose of propofol during induction,hypotension,bradycardia,respiratory depression,and injection pain were recorded.Results:Totally 26 patients were enrolled,with age of 65-78 years and BMI of 18.0-28.0 kg/m 2,and ASA gradeⅡ-Ⅲ.The ED 50 of ciprofol-induced loss of consciousness in geriatric patients undergoing abdominal surgery was 0.267(95%CI:0.250-0.284)mg/kg.Compared with anesthesia induction,MOAA/S scores,BIS,and MAP significantly decreased at 30,60,90,120,150,and 180 seconds after administration(P<0.05),while HR showed no significant change.No patients experienced injection pain,hypotension or bradycardia requiring treatment.Conclusion:The ED 50 of ciprofol-induced loss of consciousness in geriatric patients undergoing abdominal surgery was 0.267(95%CI:0.250-0.284)mg/kg.

关 键 词：环泊酚 半数有效量 老年患者 序贯法 

分 类 号：R614.2[医药卫生—麻醉学]