复合丙泊酚时奥赛利定用于人工流产术患者镇痛的半数有效剂量  

Median effective dose of oliceridine combined with propofol for analgesia during induced abortion

作　　者：李雨虹 孟凡 仇佳 尹宁 Li Yuhong;Meng Fan;Qiu Jia;Yin Ning(Department of Anesthesiology,Sir Run Run Hospital,Nanjing Medical University,Nanjing 221000,China)

机构地区：[1]南京医科大学附属逸夫医院麻醉科,南京221000

出　　处：《中华麻醉学杂志》2024年第12期1446-1449,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人工流产术患者镇痛的半数有效剂量(ED 50)。方法本研究为前瞻性研究。选择2024年9月至10月南京医科大学附属逸夫医院计划生育室行人工流产术的患者,年龄20~45岁,BMI 18~26 kg/m^(2),ASA分级Ⅰ或Ⅱ级。采用改良Dixon序贯法进行试验,奥赛利定初始剂量0.025 mg/kg,2 min后静脉注射丙泊酚2 mg/kg,奥赛利定相邻药物剂量比为1.0∶1.1。若扩张宫颈时镇痛不足(皱眉、呻吟、不自主地肢体运动,HR或MAP增加幅度>基线值的20%),则下一例患者奥赛利定剂量上调一个梯度,反之,则下调一个梯度,出现7个镇痛不足转镇痛充分的转折点时终止研究。使用Dixon序贯试验公式计算奥赛利定的ED 50及95%置信区间(CI)。记录术中低氧血症、术后头晕和恶心呕吐等不良反应的发生情况。结果本研究共纳入患者24例,复合丙泊酚2 mg/kg时,奥赛利定用于人工流产术镇痛的ED 50为0.019 mg/kg,95%CI为0.018~0.021 mg/kg。1例患者发生低氧血症,2例术后轻度头晕,所有患者未见恶心呕吐发生。结论复合2 mg/kg丙泊酚时奥赛利定用于人工流术患者镇痛的ED 50为0.019 mg/kg。Objective To determine the median effective dose(ED 50)of oliceridine for analgesia during induced abortion when combined with propofol.MethodsIn this prospective study,24 American Society of Anesthesiologists Physical Status classificationⅠorⅡpatients,aged 20-45 yr,with a body mass index of 18-26 kg/m^(2),who underwent painless induced abortion surgery at Sir Run Run Hospital affiliated to Nanjing Medical University from September to October 2024,were selected.The modified Dixon sequential method was used for the study.The initial dose of oliceridine was 0.025 mg/kg,and 2 min later propofol 2 mg/kg was intravenously injected.The ratio between the two successive doses of oliceridine was 1.0∶1.1.If the patient experienced inadequate analgesia during cervical dilation(frowning,moaning,involuntary limb movements,increase in heart rate or mean arterial pressure greater than 20%of baseline),the next patient received a higher dose of oliceridine,or conversely,a lower dose was given.The study was terminated when 7 turning points from inadequate analgesia to adequate analgesia were achieved.Dixon sequential trial formula was used to calculate the ED 50 of oliceridine and the confidence interval.The occurrence of adverse reactions such as intraoperative hypoxemia,postoperative dizziness and nausea and vomiting was recorded.ResultsTwenty-four patients were ultimately included in this study.When combined with propofol 2 mg/kg,the ED 50 of oliceridine for analgesia during painless induced abortion surgery was 0.019 mg/kg(95%confidence interval 0.018-0.021 mg/kg).One patient developed hypoxemia,and two patients experienced mild dizziness after surgery.All patients had no nausea or vomiting.ConclusionsWhen combined with 2 mg/kg of propofol,the ED 50 of oliceridine for analgesia during is 0.019 mg/kg induced abortion surgery.

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：R16[医药卫生—公共卫生与预防医学]