摘要
目的在以血浆靶控输注丙泊酚的背景下,分析纳布啡抑制宫腔镜手术患者喉罩置入反应的半数有效剂量(ED 50)。方法选择择期行全麻宫腔镜手术患者21例,年龄18~60岁,BMI 19~27 kg/m^(2),ASAⅠ或Ⅱ级。麻醉诱导采用丙泊酚血浆靶控输注,靶控浓度3.0μg/ml。当效应室浓度与血浆浓度平衡一致时,缓慢静推纳布啡,初始剂量为0.2 mg/kg。注射结束5 min且BIS 50~60时,置入喉罩。采用序贯法确定纳布啡剂量,若置入喉罩时出现阳性反应,下一例患者选用高1个梯度的剂量;反之,则选用低1个梯度的剂量。相邻剂量的比值为1.1。计算靶控输注丙泊酚的背景下,纳布啡抑制喉罩置入反应的ED 50和ED 95以及各自的95%可信区间(CI)。结果纳布啡抑制宫腔镜手术喉罩置入反应的ED 50为0.145 mg/kg(95%CI 0.125~0.165 mg/kg),ED 95为0.163 mg/kg(95%CI 0.153~0.417 mg/kg)。结论靶控丙泊酚背景下,纳布啡抑制成年宫腔镜手术患者喉罩置入反应的ED 50为0.145 mg/kg(95%CI 0.125~0.165 mg/kg)。
Objective Under the background of plasma target-controlled infusion of propofol,the half effective dose(ED 50)of nalbuphine to inhibit the laryngeal mask placement reaction of hysteroscopic surgery patients was analyzed.Methods Twenty-one patients undergoing elective general anesthesia hysteroscopic surgery,aged 18-60 years,BMI 19-27 kg/m^(2),ASA physical statusⅠorⅡ,were included in this study.Propofol plasma target-controlled infusion was used for induction of anesthesia,with a target-controlled concentration of 3.0μg/ml.When the effect chamber concentration was in balance with the plasma concentration,nalbuphine was slowly injected intravenously,with an initial dose of 0.2 mg/kg.The laryngeal mask was inserted 5 minutes after the injection and the BIS was 50-60.Sequential method was used to determine the dose of nalbuphine.If a positive reaction occurred when the mask was inserted,the next patient would choose a higher dose of 1 gradient;otherwise,a lower dose of 1 gradient would be used.The ratio of adjacent doses was 1.1.The ED 50 and ED 95 of nalbuphine and their corresponding 95%confidence intervals(CI)were calculated in the context of target-controlled infusion of propofol when the laryngeal mask placement reaction was inhibited.Results The ED 50 of nalbuphine on the response of adult female laryngeal mask placement was 0.145 mg/kg(95%CI 0.125-0.165 mg/kg),and the ED 95 was 0.163 mg/kg(95%CI 0.153-0.417 mg/kg).Conclusion Under the background of target-controlled propofol,the ED 50 of nalbuphine on the laryngeal mask implantation response in adult women is 0.145 mg/kg(95%CI 0.125-0.165 mg/kg).
作者
王得发
郑辉利
刘萍萍
郭建联
马保新
WANG Defa;ZHENG Huili;LIU Pingping;GUO Jianlian;MA Baoxin(Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2021年第6期596-598,共3页
Journal of Clinical Anesthesiology
关键词
纳布啡
半数有效剂量
喉罩
丙泊酚
靶控输注
Nalbuphine
Median effective dose
Laryngeal mask airway
Propofol
Target-controlled infusion
