联合右美托咪定滴鼻用于小儿术前镇静的艾司氯胺酮50%有效剂量及95%有效剂量测定  

Determination of 50%and 95%Effective Doses of Ketamine Combined with Dexmedetomi⁃dine Nasal Drops for Preoperative Sedation in Children

作　　者：曾雅婷 庞勇[2] ZENG Yating;PANG Yong(Clinical School of North Sichuan Medical College,Nanchong,Sichuan,China 637000;Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan,China 637000)

机构地区：[1]川北医学院临床医学院,四川南充637000 [2]川北医学院附属医院,四川南充637000

出　　处：《中国药业》2024年第S02期1-4,共4页China Pharmaceuticals

摘　　要：目的探讨艾司氯胺酮联合右美托咪定滴鼻用于小儿术前镇静时艾司氯胺酮的50%有效剂量(ED_(50))及95%有效剂量(ED_(95))。方法选取2023年5月至6月在医院择期行短小手术(手术时间≤90 min)的全身麻醉患儿20例。采用Dixon上下序贯法依次对患儿进行前瞻性双盲序贯研究。艾司氯胺酮的初始给药剂量为0.5 mg/kg,右美托咪定的给药剂量为1μg/kg。艾司氯胺酮的剂量梯度设定为0.05 mg/kg,若前一位患儿入室前25 min内镇静成功,则下一位患儿的艾司氯胺酮剂量减少0.05 mg/kg,反之则增加0.05 mg/kg。患儿的镇静水平从镇静成功到镇静失败为一个交叉点,至少6个交叉点试验结束。结果艾司氯胺酮复合右美托咪定滴鼻用于小儿术前镇静对艾司氯胺酮的ED_(50)为0.475 mg/kg[95%CI(0.455,0.495)],ED_(95)为0.509 mg/kg[95%CI(0.490,0.571)]。结论艾司氯胺酮联合右美托咪定滴鼻用于小儿术前镇静时艾司氯胺酮的ED_(50)为0.475 mg/kg,ED_(95)为0.509 mg/kg。艾司氯胺酮联合右美托咪定滴鼻用于小儿术前镇静,可缩短镇静起效时间,维持患儿心肺稳定,同时能减少单用艾司氯胺酮时潜在的拟精神副作用及苏醒期躁动。Objective To investigate the 50%effective dose(ED_(50))and 95%effective dose(ED_(95))of ketamine combined with dexmedetomidine nasal drops for preoperative sedation in children.Methods A total of 20 pediatric patients under general anesthesia who underwent elective short surgery(surgery time≤90 min)in our hospital from May to June 2023 were selected.A prospective double-blind sequential study was conducted on pediatric patients using the Dixon top-down sequential method.The initial dosage of ketamine was 0.5 mg/kg,and the dosage of dexmedetomidine was 1μg/kg.The dose gradient of ketamine was set at 0.05 mg/kg.If the previous child was successfully sedated within 25 min before entering the room,the dose of ketamine for the next child would decrease by 0.05 mg/kg,otherwise it would increase by 0.05 mg/kg.The sedation level of the patient ranged from successful sedation to failed sedation as a cross point,and at least 6 cross point trials were completed.Results The ED_(50)of ketamine combined with dexmedetomidine nasal drops for preoperative sedation in children was 0.475 mg/kg[95%CI(0.455,0.495)],and the ED_(95)was 0.509 mg/kg[95%CI(0.490,0.571)].Conclusion The combination of ketamine and dexmedetomidine nasal drops for preoperative sedation in children has an ED_(50)of 0.475 mg/kg and an ED_(95)of 0.509 mg/kg for ketamine.The combination of ketamine and dexmedetomidine for preoperative sedation in children can shorten the onset time of sedation,maintain cardiorespiratory stability,and reduce potential psychiatric side effects and agitation during the recovery period when ketamine is used alone.

关 键 词：艾司氯胺酮 右美托咪定 小儿术前镇静 Dixon上下序贯法 有效剂量 

分 类 号：R971.2[医药卫生—药品]