摘要
目的探讨年龄对丙泊酚复合依托咪酯麻醉诱导下罗库溴铵半数有效剂量(ED_(50))的影响。方法选取择期行全身麻醉颌面外科手术的160例患者作为研究对象,根据年龄的不同分为A组51例(年龄18~40岁)、B组54例(年龄41~65岁)和C组55例(年龄66~79岁)。3组均采用序贯法给予罗库溴铵,A组、B组、C组起始剂量分别为0.348、0.290、0.242 mg/kg。观察并比较3组患者麻醉诱导前(T_(0)时点)、气管插管即刻(T_(1)时点)、插管后1 min(T_(2)时点)、插管后3 min(T_(3)时点)和拔除插管即刻(T_(4)时点)的心率(HR)、血氧饱和度(SpO_(2))、平均动脉压(MAP),比较3组气管插管条件、诱导时间、起效时间、苏醒时间、苏醒后疼痛评分和不良反应,并计算罗库溴铵ED_(50)和95%可信区间(95%CI)。结果3组患者气管插管条件比较,差异无统计学意义(P>0.05)。3组患者同一时点的HR、SpO_(2)比较,差异无统计学意义(P>0.05);B组、C组的MAP高于同一时点A组,差异有统计学意义(P<0.05)。C组诱导时间、起效时间均短于A组、B组,苏醒时间长于A组、B组,差异有统计学意义(P<0.05);A组诱导时间、起效时间、苏醒时间与B组比较,差异无统计学意义(P>0.05)。3组患者苏醒后疼痛程度分级比较,差异无统计学意义(P>0.05)。C组的ED_(50)为0.267 mg/kg(95%CI为0.223~0.320),分别低于A组、B组的0.321 mg/kg(95%CI为0.297~0.347)、0.314 mg/kg(95%CI为0.283~0.348),差异有统计学意义(P<0.05);A组、B组ED_(50)比较,差异无统计学意义(P>0.05)。3组患者术前、术中和术后不良反应发生率比较,差异无统计学意义(P>0.05)。结论年龄是丙泊酚复合依托咪酯诱导麻醉时影响罗库溴铵ED_(50)的重要因素,18~40岁、41~65岁和66~79岁患者的罗库溴铵气管插管ED_(50)分别为0.321、0.314和0.267 mg/kg。
Objective To investigate the effect of age on median effective dose(ED_(50))of rocuronium on tracheal intubation following anesthesia of propofol combined with etomidate.Methods A total of 160 patients with elective operation under general anesthesia were selected as study objects,and were divided into group A(n=51,aged from 18 to 40 years),groups B(n=54,aged from 41 to 65 years)and group C(n=55,aged from 66 to 79 years)according different ages.The sequential method was conducted in three groups,with initial dosages of 0.348 mg/kg in the group A,0.290 mg/kg in the group B and 0.242 mg/kg in the group C.The heart rate(HR),blood oxygen saturation(SpO_(2)),mean arterial pressure(MAP)at the time points of induced anesthesia(T_(0)),intubation(T_(1)),1 min after intubation(T_(2)),3 min after intubation(T_(3))and extubation(T_(4))were compared,tracheal intubation condition,induction time,onset time,and awakening time,pain scores and adverse reactions were recorded.Rocuronium ED_(50) and 95%confidence interval(95%CI)were calculated.Results There was no difference in tracheal intubation condition of three groups(P>0.05).There were no differences in heart rate(HR)and SpO_(2) of three groups at each time point(P>0.05),while the levels of MAP of the group B and group C were higher than the group A at each time point(P<0.05).Compared with the group A and the group B,the induction and onset time of the group C was shorter,while the recovery time was longer(P<0.05).There were no significant differences in induction time,onset time and recovery time between the group A and the group B(P>0.05).There was no statistical significance in the grading of pain degree after awakening among three groups(P>0.05).The ED_(50) of the group C was 0.267 mg/kg(95%CI,0.223 to 0.320),which was significantly lower than 0.321 mg/kg(95%CI,0.297 to 0.347)and 0.314 mg/kg(95%CI,0.283 to 0.348)of the groups A and B(P<0.05).There was no significant difference in ED_(50) between the group A and the group B(P>0.05).There were no significant difference of in
作者
刘星初
吴婧
LIU Xingchu;WU Jing(Anesthesiology Department,Jianli City People′s Hospital,Jianli,Hubei,433300;the Affiliated Hospital of Northwest University,Xi′an Third Hospital,Xi′an,Shaanxi,433300)
出处
《实用临床医药杂志》
CAS
2021年第17期31-36,共6页
Journal of Clinical Medicine in Practice
关键词
丙泊酚
依托咪酯
罗库溴铵
半数有效剂量
气管插管
麻醉
propofol
etomidate
rocuronium
median effective dose
tracheal intubation
anaesthesia
