摘要
目的采用改良序贯法测定纳布啡抑制无痛人工流产术后宫缩痛的半数有效剂量(ED 50)。方法择期行无痛人工流产术患者28例,年龄18~35岁,BMI 18.5~28.0 kg/m^(2),ASAⅠ或Ⅱ级。纳布啡初始剂量为0.1 mg/kg,静注完毕后3 min静注丙泊酚2 mg/kg,待睫毛反射消失后行无痛人工流产术,发生体动反应时,追加丙泊酚0.5 mg/kg。术后若宫缩痛阳性,则下一例增加纳布啡剂量;反之,则降低剂量,按0.01 mg/kg梯度增减。宫缩痛阳性标准:术后20 min内出现VAS疼痛评分>3分。在研究过程中,出现7个宫缩痛阳性转阴性拐点则终止研究。采用Probit法计算纳布啡抑制宫缩痛的ED_(50)、ED_(95)及相应95%可信区间(CI)。记录呼吸暂停、低氧血症、心动过缓、低血压及恶心呕吐等发生情况。结果纳布啡抑制无痛人工流产术后宫缩痛的ED 50及其95%CI为0.099(0.090~0.107)mg/kg,ED 95及其95%CI为0.117(0.108~0.173)mg/kg。所有患者未发生呼吸暂停、低氧血症及呕吐。1例发生头晕,1例轻度恶心。结论丙泊酚静脉麻醉时,纳布啡抑制无痛人工流产术宫缩痛的ED 50为0.099 mg/kg。
Objective To determine half effective dose(ED 50)of nalbuphine inhibiting uterine contractions in painless abortion patients during anesthesia with propofol.Methods Twenty-eight pregnant women who underwent painless abortion,aged 18-35 years,with a BMI 18.5-28.0 kg/m^(2),ASA physical statusⅠorⅡ.The study was carried out using the modified Dixon sequential method.The initial dose of nalbuphine was 0.1 mg/kg,and after 3 minutes of intravenous injection of nalbuphine,propofol 2 mg/kg was administered.Painless abortion was performed after the eyelash-reflex disappeared.Propofol 0.5 mg/kg was added in case of somatic reaction.When the contraction pain occurred after surgery,nalbuphine was increased by one dose gradient in the next case.On the contrary,one dose gradient of nalbuphine was lowered in the next patient.The difference between the two adjacent doses was 0.01 mg/kg.Positive contraction pain was defined as the VAS score>3 scores within 20 minutes after surgery.The test ended after 7 crossovers were obtained.Probit analysis was used to calculate the ED 50,ED 95 and the corresponding 95%confidence interval(CI).Apnea,hypoxemia,bradycardia,hypotension,nausea and vomiting were recorded.Results When combined with propofol,the ED_(50) and 95%CI of nalbuphine in inhibiting uterine contraction pain during painless abortion were 0.099(0.090-0.107)mg/kg,the ED_(95) and 95%CI were 0.117(0.108-0.173)mg/kg.No apnea,hypoxemia and vomiting occuerred in all patients.Dizziness occurred in 1 case and mild nausea in 1 case.Conclusion The ED 50 of nalbuphine was 0.099 mg/kg for the suppression of uterine contraction pain after painless abortion when combined with propofol.
作者
张晓琴
詹锐
彭丽君
汪越
ZHANG Xiaoqin;ZHAN Rui;PENG Lijun;WANG Yue(Department of Anesthesiology,Xuancheng City people s Hospital,Xuancheng 242000,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2021年第3期253-256,共4页
Journal of Clinical Anesthesiology
关键词
纳布啡
无痛人工流产
宫缩痛
改良序贯法
半数有效剂量
Nabulphine
Painless abortion
Contraction pain
Modified sequential method
Median effective dose
