摘要
目的 评价年龄因素对异丙酚抑制胃镜检查术诱发体动反应半数有效血浆靶浓度（EC50）的影响.方法 择期胃镜检查术成年患者90例,性别不限,ASA分级Ⅰ或Ⅱ级,体重指数19-25 kg/m2.根据年龄分为3组（n=30）：18-39岁组（Ⅰ组）、40 - 64岁组（Ⅱ组）和65 - 74岁组（Ⅲ组）.Ⅰ组、Ⅱ组和Ⅲ组靶控输注异丙酚初始血浆靶浓度分别为2.5、2.0和1.5 μg/ml,达到靶浓度后行胃镜检查术.患者术中发生头部或四肢有目的较大动作,则定义为胃镜检查术诱发的体动反应.采用序贯法确定异丙酚血浆靶浓度,相邻浓度差为0.5 μg/ml,出现体动反应者,下一例采用高一级浓度;否则采用低一级浓度.用概率单位法确定异丙酚EC50及其95％可信区间（95％CI）.结果 Ⅰ组、Ⅱ组、Ⅲ组异丙酚EC50及其95％ CI分别为4.2（3.8-4.5）、4.1（3.7-4.4）和2.4（1.8- 2.7）μg/ml.与Ⅰ组相比,Ⅱ组异丙酚EC50差异无统计学意义（P＞0.05）;与Ⅰ组及Ⅱ组相比,Ⅲ组异丙酚EC50降低（P＜0.05）.结论 年龄因素可明显影响异丙酚的内脏性镇痛效应,异丙酚抑制老年患者胃镜检查术内脏性疼痛的效力较中青年患者显著增强.
Objective To evaluate the effect of age on the median-effective target plasma concentration （EC50） of propofol inhibiting body movement evoked by gastroscopy in the patients.Methods Ninety adult patients of both sexes,of ASA physical status Ⅰ or Ⅱ,with body mass index 19-25 kg/m2,scheduled for elective gastroscopy,were divided into 3 groups according to age （n =30 each）：18-39 yr group （Ⅰ group）,40-64 yr group （Ⅱ group） and 65-85 yr group （Ⅲ group）.In Ⅰ,Ⅱ,Ⅲ groups,propofol was given by target-controlled infusion with the initial target concentrations of 2.5,2.0 and 1.5 μg/ml,respectively,and gastroscopy was performed when the target concentration was achieved.Body movement was defined as the directional movement in head or four extremities during gastroscopy.The target plasma concentration of propofol was determined by up-and-down sequential trial.Each time the plasma concentration of propofol increased/decreased by 0.5 μg/ml in the next patient depending on whether or not body movement developed.The EC50 and 95 % confidence interval of propofol inhibiting gastroscopy-evoked body movement were determined using Probit analysis.Results The EC50 （95 % confidence interval） of propofol was 4.2（3.8-4.5）,4.1（3.7-4.4） and 2.4（1.8-2.7） μg/ml in Ⅰ,Ⅱ and Ⅲ groups,respectively.There was no significant difference in the EC50 of propofol between group Ⅱ and group Ⅰ.The EC50 of propofol was significantly lower in group Ⅲ than in Ⅰ and Ⅱ groups.Conclusion Age affects propofol-induced analgesia in patients with visceral pain,and the potency of propofol inhibiting visceral pain during gastroscopy in the elderly patients is significantly enhanced as compared with that in the young and middle-aged patients.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2014年第8期956-958,共3页
Chinese Journal of Anesthesiology
基金
2012年福建省泉州市科学委员会资助课题
