摘要
目的确定临床综合条件下七氟醚抑制小儿喉罩拔除反应的半数有效浓度。
方法择期短小手术患儿26例，性别不限，年龄1～5岁，体重指数15～20 kg/m2，ASA分级Ⅰ级。面罩吸入纯氧，吸入8%七氟醚，静脉注射地佐辛0.1 mg/kg麻醉诱导后置入喉罩（丁卡因胶浆涂抹喉罩背面）；吸入七氟醚、靶控输注瑞芬太尼维持麻醉。手术结束前5 min时停止输注瑞芬太尼，术毕维持七氟醚呼气末浓度稳定在目标浓度至少10 min后拔除喉罩。采用Dixon序贯法确定呼气末七氟醚浓度，第1例患儿呼气末七氟醚浓度设定为0.8%，根据喉罩拔除反应确定下一例患儿的七氟醚呼气末浓度，浓度梯度为0.1%。
结果临床综合条件下七氟醚抑制小儿喉罩拔除反应的半数有效浓度是0.59%，95%可信区间为0.55%～0.63%。
结论临床综合条件下七氟醚抑制小儿喉罩拔除反应的半数有效浓度为0.59%。
Objective To determine the median effective concentration （ECs0） of sevoflurane in- hibiting responses to laryngeal mask airway （LMA） removal in pediatric patients under comprehensive clin- ical conditions. Methods Twenty-six pediatric patients of both sexes, aged 1-5 yr, with body mass index of 15-20 kg/m2, of American Society of Anesthesiologists physical status I , scheduled for elective minor surgery, were enrolled in this study. Anesthesia was induced by inhaling 8% sevoflurane and injecting dezocine 0. 1 mg/kg. The LMA painted with Teracainum Plasmagel was inserted. Anesthesia was maintained by sevoflurane inhalation and target-controlled infusion of remifentanil. Remifentanil infusion was stopped at 5 min before the end of surgery. At the end of surgery, the end-tidal concentration of sevoflurane was main- tained at the target eoncentration for at least 10 min and then the laryngeal mask airway was removed. The end-tidal concentration of sevoflurane was determined by using Dixon＇s up-and-down sequential method. The end-tidal concentration of sevoflurane was set at 0. 8% in the first pediatric patient. Each time the concen- tration of sevoflurane increased/decreased by 0. 1% in the next pediatric patient according to patient＇s re- sponses to LMA removal. Results The ECs0 of sevoflurane inhibiting responses to LMA removal was 0. 59%, and the 95% confidence interval was 0. 55%-0. 63% in pediatric patients under comprehensive clinical conditions. Conclusion The ECs0 of sevoflurane inhibiting responses to LMA removal is 0. 59% in pediatric patients under comprehensive clinical conditions.
作者
张竞泾
卞谦
张晓颖
刘雅
康荣田
Zhang Jinxing, Bian Qian, Zhang Xi- aoying, Liu Ya, Kang Rongtian(Department of Anesthesiology, Second Hospital, Hebei Medical University, Shijiazhuang 050000, Chin)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2018年第1期59-61,共3页
Chinese Journal of Anesthesiology
关键词
麻醉药
吸入
喉面罩
剂量效应关系
药物
儿童
Anesthetics, inhalation
Laryngeal masks
Dose-response relationship, drug
Child
