复合丙泊酚时奥赛利定用于不同分娩史患者人工流产术镇痛的半数有效剂量  

Median effective dose of oliceridine combined with propofol for analgesia during induced abortion in patients with different labor histories

作　　者：张贝贝 张伟 贾佳 王振丽 李帼双 张加强 Zhang Beibei;Zhang Wei;Jia Jia;Wang Zhenli;Li Guoshuang;Zhang Jiaqiang(Department of Anesthesiology and Perioperative Medicine,Henan Provincial People′s Hospital(Zhengzhou University People′s Hospital),Zhengzhou 450003,China)

机构地区：[1]河南省人民医院(郑州大学人民医院)麻醉与围术期医学科,郑州450003

出　　处：《中华麻醉学杂志》2024年第12期1437-1440,共4页Chinese Journal of Anesthesiology

摘　　要：目的确定复合丙泊酚时奥赛利定用于不同分娩史患者人工流产术镇痛的半数有效剂量(ED 50)。方法本研究为前瞻性研究。选择河南省人民医院(郑州大学人民医院)2024年7月1日至2024年8月20日拟行人工流产术患者,ASA分级Ⅰ或Ⅱ级,年龄20~45岁,BMI 18~28 kg/m^(2)。根据有无经阴道分娩史将患者分为有分娩史组(D组)和无分娩史组(N组)。采用改良Dixon序贯法进行试验,每组首例患者静脉注射奥赛利定剂量为0.015 mg/kg,根据患者术中体动反应确定下一例奥赛利定给药剂量。若体动反应为阳性则下一例升高1个阶梯剂量,否则降低1个阶梯剂量,相邻阶梯剂量比值为1.2,直至出现7个转折点试验结束。采用Dixon序贯法公式计算ED 50及其95%置信区间。记录不良反应发生情况。结果本研究共纳入患者54例,D组25例,N组29例。D组和N组复合丙泊酚时奥赛利定用于人工流产术镇痛的ED 50及其95%置信区间分别为0.019(0.014~0.031)mg/kg和0.026(0.020~0.044)mg/kg。与D组比较,N组复合丙泊酚时奥赛利定用于人工流产术镇痛的ED 50升高(P<0.05)。2组患者静脉注射奥赛利定后均出现头晕症状,未见丙泊酚注射痛等其他不良反应发生。结论复合丙泊酚时,奥赛利定用于有经阴道分娩史和无经阴道分娩史患者人工流产术镇痛的ED 50分别为0.019 mg/kg和0.026 mg/kg;相比有经阴道分娩史患者,奥赛利定对无阴道分娩史患者的镇痛效力降低。Objective To determine the median effective dose(ED 50)of oliceridine combined with propofol for analgesia during induced abortion in patients with different labor histories.MethodsThis was a prospective study.American Society of Anesthesiologists Physical Status classification I orⅡpatients,aged 18-45 yr,with a body mass index of 20-28 kg/m^(2),scheduled for elective induced abortion at Henan Provincial People′s Hospital(Zhengzhou University People′s Hospital)from July 1,2024 to August 20,2024,were selected.Patients were divided into a delivery group(group D)and a non-delivery group(group N)based on their histories of vaginal delivery.The modified Dixon′s up and down method was used to conduct the trial.Oliceridine was intravenously injected at a dose of 0.015 mg/kg in the first patient in each group,and the dose was determined based on the intraoperative body movement.The positive response was defined as the body movement of grade 2 or higher during induced abortion.If the response was positive,the next patient received a higher dose of oliceridine,or conversely,a lower dose was given.The ratio between the two successive concentrations was 1.2,and the trial was terminated until 7 turning points were achieved.The ED 50 and 95%confidence interval were calculated using the Dixon sequential method formula.The occurrence of adverse reactions was recorded.ResultsA total of 54 patients were included in this study,with 25 in group D and 29 in group N.The ED 50 and 95%confidence interval of oliceridine for painless abortion were 0.019(0.014-0.031)mg/kg and 0.026(0.020-0.044)mg/kg in group D and group N,respectively.Compared with group D,the ED 50 of oliceridine for analgesia during induced abortion was significantly increased when combined with propofol in group N(P<0.05).Patients in both groups experienced dizziness after intravenous oliceridine injection,and no other adverse reactions such as injection pain were observed.ConclusionsWhen combined with propofol,the ED 50 of oliceridine for analgesia is 0.019 mg/

关 键 词：镇痛药 阿片类 二异丙酚 流产 人工 剂量效应关系 药物 

分 类 号：R71[医药卫生—妇产科学]