摘要
目的探讨不同靶浓度的舒芬太尼复合丙泊酚靶控输注（targeted-controlled infusion，TCI）抑制气管插管反应的丙泊酚半数有效血浆浓度（the median effective plasmac oncentration，Cp50）。方法研究对象为94例择期全麻拟行气管插管手术患者，ASAI．Ⅲ级，年龄在60岁～79岁。根据年龄段和舒芬太尼靶浓度的不同按随机数字表法分为4组，A组为60岁．69岁、0．2μg/L；B组为60岁～69岁、0．3μg/L；C组为70岁-79岁、0．2μg/L；D组为70岁-79岁、0．3μg/L。试验以效应室浓度TCI舒芬太尼，待舒芬太尼血浆浓度与效应室浓度平衡后，以血浆靶浓度TCI丙泊酚，意识消失后给予0．2ms／ks的顺阿曲库铵，待丙泊酚的血浆浓度和效应室浓度平衡且静注顺阿曲库铵达3min后行气管插管。丙泊酚的血浆靶浓度按序贯法确定。结果A组患者有效抑制气管插管反应的丙泊酚的Cp50为3．60mg/L，9铴可信区间（confidenceinterval，CI）为3．44m/L-,326m扎；B组患者Cp50为2．03mg／L，95％CI为1．88mg/L～2．20mg／L；C组患者Cp50为2．70mg／L，95％CI为2．56mg／L～2．84mg／L；D组患者Cp50为1．97mg／L，95％CI为1．81mg／L～2．12mg／L。结论随着舒芬太尼的效应室靶浓度的增加以及年龄的增加，丙泊酚的Cp50明显降低。
Objective To investigate the median effective plasma concentration （CpS0） of propofol blunting cardiovascular responses to tracheal intubation with sufentanil at different targeted concentrations on anesthesia induction in elderly patients. Methods Ninty-four patients （60 years-79 years） with an American Society of ASA physical status of Ⅰ -Ⅲ, undergoing scheduled surgery under general anesthesia were randomly allocated into one of the four groups ： group A, B, C and D. The patients in group A and group B （60 years-69 years） and the ones in group C and group D（70 years-79 years） received sufentanil with a target effect concentration of 0.2 μg/L,0.3 μg/L respectively. Induction of anesthesia was initiated by targeted-controlled infusion （TCI） of sufentanil at target effect-site concentration and was maintained stable before administration of propofol, determined by up and down sequential test. At the moment of loss of consciousness, eisatracurium 0.2 mg/kg was administered and intubated after 3 min. Results The CpSO of propofol were 3.60, 2.03, 2.70, 1.97 mg/L with 95% confidence interval of 3.44 rag/L-3.76 rag/L, 1.88 mg/L- 2.20 mg/L, 2.56 mg/L-2.84 mg/L and 1.81 mg/L-2.12 mg/L in group A, B, C and D respectively. Conclusions With the concentrations of sufentanil or increased age, the Cp50 of propofol decreases in elderly patients.
出处
《国际麻醉学与复苏杂志》
CAS
2012年第5期294-297,共4页
International Journal of Anesthesiology and Resuscitation
关键词
丙泊酚
舒芬太尼
靶控输注
半数有效血浆浓度
气管插管
老年人
Propofol
Sufentanil
Targeted-controlled infusion
The median effective plasma concentration
Tracheal intubation
The elderly
