性别因素对复合环泊酚时阿芬太尼抑制胃镜置入反应量效关系的影响  

Effect of gender on the dose effect relationship of alfentanil in inhibiting gastroscopic insertion response when combined with ciprofol

作　　者：徐海 朱婷婷 周红梅 XU Hai;ZHU Tingting;ZHOU Hongmei(Department of Anesthesiology,Second Hospial of Jiaxing.Jiaxing 314000,CHINA)

机构地区：[1]嘉兴市第二医院麻醉科,浙江314000

出　　处：《江苏医药》2024年第7期698-701,共4页Jiangsu Medical Journal

基　　金：嘉兴市科技计划项目(2022AD30027)。

摘　　要：目的 探讨性别因素对复合环泊酚时阿芬太尼抑制胃镜置入反应量效关系的影响。方法 将64例行无痛胃镜检查术的患者分为男性组(M组,31例)和女性组(F组,33例)。两组首例患者均给予阿芬太尼7μg/kg, 30 s后给予环泊酚0.4 mg/kg,待患者睫毛反射消失且改良警觉/镇静评分≤3分时置入胃镜。若出现胃镜置入阳性反应(定义为置入胃镜过程中患者出现吞咽、呛咳、体动等并影响检查质量),则下一例患者阿芬太尼用量增加1μg/kg,反之减少1μg/kg。重复此过程直至出现9个转折点。采用Probit法计算复合环泊酚时阿芬太尼抑制患者胃镜置入反应的半数有效剂量(ED_(50))和95%有效剂量(ED_(95))。结果 M组31例均完成试验,其中的15例出现阳性反应;F组33例均完成试验,其中的16例出现阳性反应。复合环泊酚0.4 mg/kg时,M组阿芬太尼抑制胃镜置入反应的ED_(50)及其95%CI为6.760(5.196~8.048)μg/kg, ED_(95)及其95%CI为9.544(8.174~22.438)μg/kg;F组阿芬太尼抑制胃镜置入反应的ED_(50)及其95%CI为5.845(4.841~6.741)μg/kg, ED_(95)及其95%CI为8.128(7.059~14.182)μg/kg。F组阿芬太尼抑制胃镜置入反应的ED_(50)低于M组(P<0.01)。结论 复合环泊酚0.4 mg/kg时,女性患者阿芬太尼抑制胃镜置入反应的麻醉效力大于男性患者。Objective To explore the effect of gender on the dose-effect relationship of alfentanil in inhibiting gastroscopic insertion response when combined with ciprofol.Methods Sixty-four patients underwent painless gastroscopy were divided into two groups of M(male patients,31 cases)and F(female patients,33 cases).The first patient in both groups was given alfentanil 7μg/kg,which was followed by ciprofol 0.4 mg/kg 30 seconds later.Gastroscope was placed when the eyelash reflex disappeared and the modified alertness/sedation score was<3 points.The positive reaction was defined as the occurrence of swallowing,choking,body movement and so on during the process of gastroscope insertion,which affected the quality of examination.If positive reaction occurred,the dosage of alfentanil in the next patient was increased by 1μg/kg,otherwise decreased by 1μg/kg.The process was repeated until 9 turning points occurred.Probit method was used to calculate the median effective dose(ED_(50))and 95%effective dose(ED_(95))of alfentanil combined with ciprofol in inhibiting gastroscopic insertion response.Results All 31 cases in group M completed the experiment,of whom 15 cases showed positive reaction.All 33 cases in group F completed the experiment,of whom 16 cases showed positive reaction.When combined with ciprofol 0.4 mg/kg,the ED_(50)(95%CI)and ED_(95)(95%CI)of alfentanil in inhibiting gastroscopic insertion response were 6.760(5.196-8.048)μg/kg and 9.544(8.174-22.438)μg/kg in group M,which were 5.845(4.841-6.741)μg/kg and 8.128(7.059-14.182)μg/kg in group F.The ED_(50) of alfentanil in inhibiting gastroscopic insertion response in group F was significantly lower than that in group M(P<0.01).Conclusion The anesthetic efficacy of alfentanil in inhibiting gastroscopic insertion response in female patients is greater than that in male patients when combined with ciprofol.

关 键 词：环泊酚 阿芬太尼 性别 胃镜检查 量效关系 

分 类 号：R614[医药卫生—麻醉学]