摘要
目的:确定高海拔地区不同民族患者丙泊酚靶控输注下意识消失界点相对应的效应室浓度、血浆浓度、剂量的EC05、EC50和EC95(EC指最低有效浓度)及听觉诱发电位指数(AAI值)参数。方法:择期102例ASA(I^II)级的腹腔镜胆囊切除术(LC)患者,根据民族不同将研究资料分为三组:A组(汉族)、B组(藏族)、C组(回族),监测听觉诱发电位AAI及平均动脉压(MAP)、心率(HR)、氧饱和度(SpO2)值。用靶浓度控制输注法输注丙泊酚,采用阶梯上升浓度递增法给药,以预期效应室浓度1.2μg·mL-1为起点,每次丙泊酚的效应室浓度和血浆浓度达到一致后,加注丙泊酚浓度0.3μg·mL-1,直患者意识消失。采用概率单位回归分析计算意识消失时丙泊酚的效应室浓度、血浆浓度和相对应剂量的EC05、EC50、EC95值和AAI。结果:不同民族患者靶控输注(TCI)丙泊酚意识消失时效应室浓度的EC05、EC50、EC95值分别为A组:2.01μg·mL-1、3.01μg·mL-1、4.00μg·mL-1;B组:1.77μg·mL-1、3.01μg·mL-1、4.25μg·mL-1;C组:1.02μg·mL-1、2.44μg·mL-1、3.85μg·mL-1,血浆浓度的EC05、EC50、EC95分别为A组:2.42μg·mL-1、3.47μg·mL-1、4.52μg·mL-1;B组:2.14μg·mL-1、3.50μg·mL-1、4.87μg·mL-1;C组:1.38μg·mL-1、2.87μg·mL-1、4.36μg·mL-1,相应剂量的EC05、EC50和EC95分别为A组:0.87mg/kg、1.60 mg/kg、2.33mg/kg;B组:0.62mg/kg、1.58mg/kg、2.54mg/kg;C组:0.11mg/kg、1.16mg/kg、2.21mg/kg。患者意识消失时AAI值均在30以下。结论:高海拔地区患者TCI丙泊酚意识消失时效应室浓度、血浆浓度、相应剂量的EC05、EC50和EC95等临床参数回族与汉族、藏族比较有明显差异(P<0.05),回族丙泊酚用药偏小。
Objective：To determine propofol effect - site concentration and I.evel of ECs0, EC, ECg and AAI at loss of consciousness time （LOC time） in patients from different nationalities at high altitude. Methods ：102 patients for elective operation of laparoscopic cholecystectomy （LC） were divided into the group A （ Hart nationality）, B （Ti- betan） and C （Hui nationality）, then propofol was given by target control infusion （TCI） at a point of expected effect -site concentration of 1.21a4g .mL-1 and increased progressively with 0.3lag . mL-1 after the effect -site con- centration was consistent with plasma level up to loss of consciousness. And the electric potential evoked by auditory （AM value）,MAP,HR,SpO2 were detected. Probability unit regression analysis was used to calculate the effect - site concentration and plasma level of propofol, EC05 ,EC50, EC95 and AII value of correspondent dose at I）C time. Results：At LOC time, EC0·,ECs0 and EC95 level in group A was 2.011.μg · ml-1,3.01μg/ml and 4.00μg · mL-1 re spectively; 1.771.μg - mL-1,3.011μg · mL-1 and 4. 25μg · mL-1 for group B; 1.02μg · mL-1,2.441xg · mL-1 and 3.01 · mL-1 for group C; and plasma level of EC· ,ECs0 and EC95 in group A was 2.42μ g · mL-1,3.47μ g · mL- and 4.52μg · mL-1 respectively; 2.14μg · mL-1 ,3.50μg · mL-1 and 4.87μg · mL-1 for group B; 1. 38μg · mL-1 , 2.87μg · mL-1 and 4.361μg · mL-1for group C. EC ,ECs0 and EC95 of relevant dose at LOC time was 0.87mg/kg, 1.60μg/kg and 2.33mg/kg for group A; 0.62mg/kg,1.58mg/kg and 2.54mg/kg for group B; 0.11 μg/kg,1.16μg/ kg and 2.21mg/kg for group C, respectively. AAI values in the three groups were less than 30 at LOC time. Conclu sions： At LOC time, there are significant differences （P 〉 0.05） in effectsite concentrations, plasma concentrations and corresponding doses of EC0s ,EC50 ,EC95 under TCI propofol in patients from Han, Tibetan and Hui nationalities, and the dose of propofol is lower in Hui nationality than others.
出处
《青海医药杂志》
2013年第5期1-4,共4页
Qinghai Medical Journal
基金
青海省(应用)基础研究计划项目(编号2011-Z-737)
