摘要
目的:确定复合环泊酚时舒芬太尼抑制帕金森病患者气管插管反应的半数有效剂量(ED 50)。 方法:本研究为前瞻性研究。选择南京医科大学附属脑科医院2022年7月至2024年1月择期行脑深部刺激器植入术的帕金森病患者,ASA分级Ⅰ或Ⅱ级,年龄18~64岁,BMI 18.5~30.0 kg/m^(2),Mallampati气道分级Ⅰ或Ⅱ级。依次静脉注射舒芬太尼、环泊酚0.40 mg/kg及罗库溴铵0.60 mg/kg麻醉诱导,待肌松起效后行气管插管术。气管插管后2 min内HR、MAP升高幅度超过基础值20%定义为阳性反应。舒芬太尼初始剂量为0.36 μg/kg,根据是否发生气管插管阳性反应,确定下一例患者舒芬太尼剂量,相邻剂量比为1.2。根据Dixon-Mood法计算舒芬太尼抑制气管插管反应的ED 50和95%可信区间。 结果:复合环泊酚时舒芬太尼抑制帕金森病患者气管插管反应的ED 50(95%可信区间)为0.335(0.298~0.378) μg/kg。 结论:复合0.40 mg/kg环泊酚时,舒芬太尼抑制帕金森病患者气管插管反应的ED 50为0.335 μg/kg。
Objective To determine the median effective dose(ED 50)of sufentanil in inhibiting responses to tracheal intubation when combined with ciprofol in patients with Parkinson′s disease.Methods This was a prospective study.American Society of Anesthesiologists Physical Status classificationⅠorⅡpatients with Parkinson′s disease,aged 18-64 yr,with body mass index of 18.5-30.0 kg/m^(2),of Mallampati gradeⅠorⅡ,undergoing elective deep brain stimulator implantation with tracheal intubation in the Brain Hospital Affiliated to Nanjing Medical University from July 2022 to January 2024,were selected.Sufentanil,ciprofol 0.40 mg/kg and rocuronium 0.60 mg/kg were administrated intravenously and sequentially,and endotracheal intubation was performed after onset of muscle relaxation.A positive response was defined as an increase in heart rate or mean arterial pressure by more than 20%of the baseline value within 2 min after tracheal intubation.The initial dose of sufentanil was set at 0.36μg/kg,the dose in the next patient was determined according to the response to tracheal intubation,and the ratio between the two successive doses was 1.2.The ED 50 and 95%confidence interval of sufentanil in inhibiting responses to tracheal intubation were calculated using the Dixon-Mood method.Results The ED 50(95%confidence interval)of sufentanil in inhibiting responses to tracheal intubation was 0.335(0.298-0.378)μg/kg when combined with ciprofol.Conclusions When combined with ciprofol 0.40 mg/kg,the ED 50 of sufentanil in inhibiting responses to tracheal intubation is 0.335μg/kg in patients with Parkinson′s disease.
作者
梅凤美
章文斌
曾琼
阮义峰
陆军
Mei Fengmei;Zhang Wenbin;Zeng Qiong;Ruan Yifeng;Lu Jun(Department of Anesthesiology,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China;Department of Functional Neurosurgery,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2024年第6期714-717,共4页
Chinese Journal of Anesthesiology
基金
江苏省重点研发计划产业前瞻与关键技术研发项目(BE2022049,BE2022049-1)。
关键词
舒芬太尼
环泊酚
插管法
气管内
剂量效应关系
药物
帕金森病
Sufentanil
Ciprofol
Intubation,endotracheal
Dose-response relationship,drug
Parkinson disease
