丙泊酚麻醉下舒芬太尼抑制病人气管插管-第三军医大学学报.DOCVIP

作者单位450006 郑州市, 河南省直第三人民医院麻醉科（钱晓岚）450052 郑州市,郑州大学第一附属医院麻醉科 (张卫) 郑州大学第一附属医院临床药理基地 (阚全程) 通讯作者：张卫（E-mail:Zhangw571012 @126.com） 丙泊酚麻醉下舒芬太尼抑制气管插管 反应的半数有效浓度 钱晓岚1 张卫2 阚全程3 （1河南省直第三人民医院麻醉科，河南省郑州市 450006；2.郑州大学第一附属医院麻醉科，河南省郑州市 450052；3.郑州大学临床药理基地，河南省郑州市 450052） 【摘要】 目的 确定异丙酚靶控输注时舒芬太尼抑制气管插管反应的半数有效浓度(Ce50)。方法 择期全麻手术病人，年龄30-50岁，ASAⅠ-Ⅱ级，BMI﹤30kg/m2, 病人入手术室后监测生命体征，记录MAP、HR 、SPO2。以效应室浓度靶控输注舒芬太尼, 3分钟后给予血浆靶浓度为3μg/ml的丙泊酚，病人意识消失给予0.1mg/kg的维库溴铵, 肌松满意后行气管插管。舒芬太尼效应室靶浓度按序贯法确定，舒芬太尼靶控浓度从0.4ng/ml开始，相邻靶浓度之间比率为1．2，气管插管反应的标准：气管插管后2min内MAP高于基础值的15%和/或HR大于90次/分。结果3μg/ml的丙泊酚麻醉下舒芬太尼抑制气管插管反应的Ce50为0.32ng/ml，95％可信区间为0.3-0.36ng/ml。结论 在复合靶控输注3μg/ml的丙泊酚时，舒芬太尼抑制气管插管反应的Ce50为0.32ng/ml。 【关键词】哌啶类；插管法，气管内；药物释放系统；剂量效应关系，药物；丙泊酚 Half-effect target effect-site concentration of sufentanil blunting cardiovascular responses to tracheal intubation during propofol administration QIAN Xiao-lan, , .Department of Anesthesiology,The Third People Hospital of Henan Province .ZHANG Wei, KAN Quan-cheng，.Department of Anesthesiology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052 ,China 【Abstract】 Objective To determine the half-effective target effect-site concentration(Ce50) of sufentanil blunting cardiovascular responses to tracheal intubation during propofol administration.Methods ASA class Ⅰ-Ⅱ patient aged 30-50 yr with body weight index ﹤30kg/m2 undergoing elective surgery under general anesthesia? were enrolled in this study. Induction of anesthesia was initiated by TCI of sufentanil at the target effect-site concentration with the Bovill model.3 minite latter, TCI of propofol at the target plasma concentration of 3μg/ml.began .After the loss of consciousness,vecuronium 0.1mg/kg was administrated.Target effect-site concentration of sufentanil was determined by up and down sequential test,The initial concentration was set at 0.4ng/ml.The ratio of two successive target effect-site concentration was1.2.Cardiovascular responses were defined as an increase in MAP≥15% an