摘要
目的探究汉族与维吾尔族EHH患者行腹腔镜手术麻醉诱导顺利置入喉罩时靶控输注丙泊酚的半数有效血浆浓度(EC50),为临床合理用药及实施个体化麻醉提供参考。方法前瞻性分析2016年1月至2017年8月,新疆维吾尔自治区人民医院微创外科行腹腔镜下食道裂孔疝修补手术的58名EHH患者的临床资料,其中汉族组30例,维吾尔族组28例。2组均釆用改良序贯法靶控输注丙泊酚,首例患者丙泊酚血浆靶控的起始浓度为3. 5 ug/ml,浓度调整梯度设定为0. 5 ug/ml,待患者意识消失、睫毛反射消失时置入喉罩,若置入喉罩效果满意,下1例靶控丙泊酚浓度降低一个梯度,若置入喉罩效果不满意,下1例靶控丙泊酚浓度增加一个梯度,并比较2组患者术中各时间段(入室后、置入喉罩前、置入喉罩后1 min)的血流动力学、BIS等指标。结果汉族患者靶控输注丙泊酚置入喉罩的半数有效血浆浓度为3. 77μg/ml,其相对应的95%CI为3. 61~3. 91μg/ml;维吾尔族患者靶控输注丙泊酚置入喉罩的半数有效血浆浓度4. 31μg/ml,其相对应的95%CI为4. 16~4. 46μg/ml。结论维吾尔族EHH患者行腹腔镜手术靶控输注丙泊酚置入喉罩的EC50高于汉族,请广大麻醉医师引起注意,并进行针对性干预。
Objective Study on the median effective target plasma concentration（EC 50 ）of propofol for target controlled infusion（TCI）inhibiting laryngeal mask insertion response during anesthesia induction of laparoscopic surgery in Xinjiang Uygur and Han EHH patients,To provide guidance for rational drug use and individualized anesthesia. Methods Collected the 28 cases in Uygur group and 30 cases in Han group who underwent laparoscopic surgery in the hospital during the period from January 2016 to August 2017 were enrolled in the study.The EC 50 of propofol for TCI during anesthesia induction was calculated by Dixon up-and-down method.By adopting sequential test and propofol with the first patient with the concentration of 3.5 ug/ml and grade differential of 0.5 ug/ml.The method of anaesthesia and surgery in the treatment were summarized.The intraoperative blood flow;BIS（bispectral index）were observed. Results The effective plasma concentration of propofol to achieve successful laryngeal mask airway insertion in 50% of Han and Uygur patients was 3.77ug/ml and 4.31ug/ml,while 95% Confidence Intervals is 3.61～3.91 ug/ml.and 4.16～4.46 ug/ml. Conclusion The EC 50 of propofol for TCI inhibiting laryngeal mask insertion response in Xinjiang Uygur EHH patients was significantly higher than that of the Han patients.Please pay attention to the anesthesiologist.
作者
梅静
刘松涛
Mei Jing;Liu Songtao(Department of Anaesthesia,People′ s Hospital of Xinjiang Ugyur AutomonousRegeion 830001 Urumqi,China;Department of Anesthesiology,Fourth Affiliated Hospital of Xinjiang Medical University,830000 Urumqi,China)
出处
《中华胃食管反流病电子杂志》
2018年第1期15-18,共4页
Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)
基金
新疆维吾尔自治区人民医院院内基金项目(20160308)
关键词
疝
食道裂孔
丙泊酚
半数有效血浆浓度
民族
Hernia，hiatal
Propofol
The median effective target plasma concentration；Nationality
