摘要
目的研究老年病人无肌松药气管插管不同瑞芬太尼剂量对呼气末七氟烷浓度的影响。方法选择择期行全身麻醉需气管插管患者,随机分成三组:C组(对照组)30例,未用瑞芬太尼;F1组25例,瑞芬太尼1ug/kg,60s缓慢给药,随后瑞芬太尼0.1ug·kg-1·min-1输注;F2组,31例,瑞芬太尼1ug/kg,60s缓慢给药,随后瑞芬太尼0.2ug·kg-1·min-1输注。所有患者给与初始七氟烷浓度为5%,当患者眨眼反射消失后,三组分别输注0.9%氯化钠注射液,瑞芬太尼0.1ug·kg-1·min-1,瑞芬太尼0.2ug·kg-1·min-1,当呼气末七氟烷浓度稳定10min后,行气管插管。下一例患者呼气末七氟烷浓度根据Dixon序贯法确定。结果 C组气管插管呼气末七氟烷ED50为4.90%,95%可信区间为(4.75～5.05)%;F1组气管插管呼气末七氟烷ED50为3.13%,95%可信区间为(2.93～3.33)%;F2组气管插管呼气末七氟烷ED50为1.53%,95%可信区间为(1.40～1.66)%;F1组、F2组呼气末七氟烷浓度与C组比分别减少了36.12%、68.78%。结论瑞芬太尼剂量依赖性减少老年患者未用肌松药气管插管七氟烷呼气末浓度。
Objective To investigate the effects of different does of remifentanil on the end-tidal concentration of sevoflurane required for tracheal intubation in elder without the use of neuromuscular blocking drugs. Methods Eighty-six elder patients, were randomly allocated to receive no remifentanil （group C） or remifentanil 0.1 ug·kg-1· min-1 （group F1）, 0.2 μg·kg^-1·min^-1group F2）. All patients were anaesthetised using 5% sevoflurane. After loss of eyelash reflex, remifentanil 1 ug/kg was injected over 1 min followed by an appropriate group-dependent infusion and the end-tidal sevoflurane concentration was changed. Predetermined end-tidal sevoflurane concentrations for each group were determined using the Dixon up-and-down method. After the target concentration of sevoflurane was maintained for 10 min, the elder＇s trachea was intubated. Results The end-tidal concentration （SD） of sevoflurane for successful tracheal intubation in 50% of elder （ED50） were 4.90% （95% CI 4.75%-5.05%） in control, 3.13%（95% CI 2.93%-3.33% ） and 1.53% （95% CI 1.40%-1.66% ） in F1 group and F2 group, respectively. The end-tidal concentration of sevoflurane decreased 36.12% in F1 group, 68.78% in F2 group compared with C group. Conclusions Continuous intravenous infusion of remifentanil produced a dose-dependent decrease in the end-tidal concentration of sevoflurane necessary for tracheal intubation in elder without the use of neuromuscular blocking drug.
出处
《全科医学临床与教育》
2010年第3期251-253,共3页
Clinical Education of General Practice
关键词
瑞芬太尼
老年患者
呼气末七氟烷浓度
气管插管
remifentanil
elder
the end-tidal concentration of sevoflurane
tracheal intubation
