摘要
目的 评价全麻患者靶控输注（TCI）或静脉注射瑞芬太尼引起呼吸抑制的量效关系。方法 择期全麻患者40例，ASAⅠ或Ⅱ级，年龄18～60岁，体重45～80奴。随机分为TCI组和静脉注射组（V组）（n=20）。按照序贯法进行试验，TCI组靶控输注瑞芬太尼7min，相邻血浆靶浓度之间的梯度为70％，分别设为1．7、2．9、4．9和8．3／μg／L，初始靶浓度8．3μg／L；V组静脉注射时间10s，相邻靶剂量之间梯度为62％，分别设为0．8、1．3、2．1、3．3和5．3μg／kg，初始靶剂量5．3μg／kg。若上一例患者未发生呼吸抑制，则应用高一级的血浆靶浓度或剂量；若发生呼吸抑制，则应用低一级的血浆靶浓度或剂量。发生呼吸抑制的标准为脉搏血氧饱和度≤90％。结果 TCI瑞芬太尼引起呼吸抑制的半数血浆靶浓度为3．97／μg／L，95％可信区间为3．16～4．99／μg／L；静脉注射瑞芬太尼引起呼吸抑制的半数有效剂量为2．50／μg／kg，95％可信区间为1．93～3．24μg／kg。结论 全麻患者TCI瑞芬太尼引起呼吸抑制的半数血浆靶浓度为3．97μg／L；静脉注射瑞芬太尼引起呼吸抑制的半数有效剂量为2．50μg／kg。
Objective To examine the dose-response relationship of remifentanil-induced ventilatory depression. Methods Forty ASAⅠ or Ⅱ patients aged 18-60 yr weighing 45-80 kg undergoing elective surgery under general anesthesia were randomly divided into 2 groups （ n = 20 each） ： groupⅠ remefentanil TCI and group Ⅱ remifentanil iv bolus injection. Cp50 （the target plasma remifentanil concentration that caused ventilatory depression in 50% of patients） in TCI group （group Ⅰ ） and ED50 in remifentanil bolus injection group （group Ⅱ） were determined by up-and-down sequential trial. Each time the Cp and bolus dose increased/decreased by 70% （in TCI group） and 62% （in bolus injection group） respectively. The initial Cp was set at 8.3 μg/L and the initial bolus dose was 5.3 μg/kg. Venfilatory depression was defined as SpO2≤ 90 %. Results The venfilatory depression Cp50 of remifentnil TCI was 3.97μg/L （95 % confidence interval was 3.16-4.99μg/L）. The venfilatory depression EDs0 of remifentanil was 2.50 μg/kg （95% confidence interval was 1.93-3.24 μg/kg）. Conelnsion The venfilatory depression Cp50 of remifentanil TCI and ED50 of remifentanil by bolus injection are 3.97 μg/L and 2.50 μg/kg repectively.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2008年第3期211-213,共3页
Chinese Journal of Anesthesiology
基金
海南省卫生厅基金资助项目（琼卫2005-78）
关键词
哌啶类
呼吸
药物释放系统
麻醉
静脉
Piperidines
Respiration
Drug delivery systems
Anesthesia,intravenous
