布托啡诺对依托咪酯致患者意识消失作用的影响

目的:探讨15 μg/kg布托啡诺对依托咪酯致患者意识消失95％有效剂量(ED95)的影响.方法:择期行无痛肠镜检查患者80例,性别不限,年龄42 ～60岁,美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级.将患者随机分为两组:依托咪酯组(E组)、依托咪酯复合布托啡诺15μg/kg组(EB组).EB组患者予静脉注射重酒石酸布托啡...

Effects of butorphanol on ED95 of etomidate for loss of consciousness

Objective: To determine the effects of butorphanol of 15 μg/kg on 95% effective dose(ED95) of etomidate for loss of consciousness.Methods:A total of 80 patients undergoing painless colonoscopy were studied, male or female,aged 42 to 60 years old, and American association of anesthesiologists (ASA) grade Ⅰ or Ⅱ. These patients were allocated to two groups in accordance with the random number table:etomidate alone (Group E), or etomidate combined with butorphanol of 15 μg/kg for intravenous premedication(Group EB).For Group EB,15 μg/kg of butorphanol were intravenously injected, and after 3 minutes the etomidate dosage was determined using the biased coin design up-and-down sequential method. The first dose of etomidate was 0.04 mg/kg, and the adjacent dose gradient was 0.04 mg/kg. For Group E, butorphanol was replaced by normal saline of the same volume, and the etomidate dosage was determined in the same way as Group EB. ED95 of etomidate for loss of consciousness of every group was determined by the isotonic regression with pooled adjacent violators algorithm separately. The bootstrap was used to estimate the confidence interval(95%CI) of ED95. Results: ED95 and the 95% CI of etomidate for loss of consciousness was 0.220(0.190-0.262)mg/kg in Group E, 0.159(0.125-0.179) mg/kg in Group EB. The ED95 of etomidate for loss of consciousness in Group EB was significantly lower than that in Group E(P<0.05). Compared with Groups E, the incidence of myoclonus was lower in Group EB(P<0.05). Conclusion: Butorphanol of　15 μg/kg for intravenous premedication can significantly reduce the ED95 of etomidate for loss of consciousness and the incidence of myoclonus.