复合布托啡诺时环泊酚用于乳腺旋切术的半数有效剂量  

Median Effective Dose of Cipepofol Combined with Butorphanol in Minimally Invasive Breast Gyrotomy

作　　者：张怡 李娅茹 李芳坤 李一 朱建坡[1] ZHANG Yi;LI Ya-ru;LI Fang-kun;LI Yi;ZHU Jian-po(Department of Anesthesiology,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院麻醉科,郑州450000

出　　处：《中国合理用药探索》2025年第2期68-72,共5页Chinese Journal of Rational Drug Use

基　　金：河南省中医药科学研究专项课题(2022JDZX033)。

摘　　要：目的:测定监护麻醉下复合布托啡诺时环泊酚用于乳腺旋切术的半数有效剂量(ED_(50))。方法:选取2023年12月1日~2024年2月28日期间于某院择期行乳腺旋切术的27例患者作为研究对象,麻醉开始时静脉注射酒石酸布托啡诺注射液20μg/kg,3 min后注射环泊酚注射液,待脑电双频指数(BIS)≤50或改良警觉/镇静评分(MOAA/S)≤1分后开始手术。按照改良Dixon序贯法进行试验,首例患者环泊酚注射液的剂量设定为0.4 mg/kg。若患者在切皮时或3 min内MOAA/S评分≥4分或出现皱眉、体动等影响手术操作的反应,判定为阳性反应,则下一例患者剂量增加0.04 mg/kg,否则降低0.04 mg/kg,出现7个阳性反应和阴性反应交叉点时终止试验。结果:复合布托啡诺时环泊酚用于乳腺旋切术的ED_(50)为0.452 mg/kg(95%CI 0.421~0.486 mg/kg),ED95为0.520 mg/kg(95%CI0.486~0.714 mg/kg)。结论:在监护麻醉下,复合布托啡诺时环泊酚用于乳腺旋切术的ED_(50)为0.452 mg/kg(95%CI 0.421~0.486 mg/kg)。Objective:To determine the median effective dose(ED_(50))of cipepofol combined with butorphanol in minimally invasive breast gyrotomy under monitored anesthesia care.Methods:A total of 27 patients undergoing elective minimally invasive breast gyrotomy in a hospital from December 1,2023 to February 28,2024 were selected as the study subjects.Butorphanol tartrate injection(20μg/kg)was administered intravenously at the onset of anesthesia,and cipepofol injection was injected 3 minutes later.The surgery was started once bispectral index(BIS)was≤50 or the modified observer's assessment of alertness/sedation scale(MOAA/S)scale was≤1.The study was conducted according to the modified Dixon sequential method,with the initial dose of cipepofol injection set at 0.4 mg/kg for the first patient.If the patient showed a MOAA/S score of≥4 during skin incision or within 3 minutes,or showed reactions such as frowning or body movement that affected the surgical procedure,it was considered a positive response.In this case,the dose for the next patient would be increased by 0.04 mg/kg.Otherwise,the dose would be decreased by 0.04 mg/kg.The study would be terminated when seven crossover points between positive and negative responses were observed.Results:The ED_(50) of cipepofol combined with butorphanol in minimally invasive breast gyrotomy was 0.452 mg/kg(95%CI 0.421~0.486 mg/kg)and the ED95 was 0.520 mg/kg(95%CI 0.486~0.714 mg/kg).Conclusion:The ED_(50) of cipepofol combined with butorphanol in minimally invasive breast gyrotomy under monitored anesthesia care was 0.452 mg/kg(95%CI 0.421~0.486 mg/kg).

关 键 词：环泊酚 布托啡诺 乳腺旋切术 监护麻醉 半数有效剂量 

分 类 号：R614[医药卫生—麻醉学]