国人女性靶控输注丙泊酚复合瑞芬太尼麻醉喉罩置入时瑞芬太尼ECe50的测定

【摘要]】目的 观察国人女性靶控输注不同丙泊酚浓度复合瑞芬太尼麻醉喉罩置入时瑞芬太尼ECe50值。 方法 50例女性乳腺良性手术患者随机分为2组（n=25），A组：靶控输注丙泊酚效应室浓度3.0 μg/ml；B组：靶控输注丙泊酚效应室浓度4.0 μg/ml（均为Marsh药代模型），待其效应室浓度和血浆浓度达平衡后给予靶控输注效应室浓度瑞芬太尼（Minto药代模型），运用Dixon’s序贯法确定喉罩置入时瑞芬太尼浓度，10分钟后置入喉罩并观察喉罩置入条件与成功率，计算出相应的瑞芬太尼适宜靶浓度（ECe50值）。 结果 两组患者年龄、体重、身高无显著性差异（P＞0.05），两组血流动力学无显著性差异（P＞0.05）。A组瑞芬太尼ECe50值为2.89（95％CI 2.72～3.08）ng/ml；B组：瑞芬太尼ECe50值为1.58（95％CI 1.41～1.77）ng/ml。 结论 丙泊酚剂量的增加可减少喉罩置入时瑞芬太尼的ECe50。

Determining the ECe50 of remifentanil with target concentration of propofol for insertion of laryngeal mask in Chinese women

【Abstract】 Objective To observe and compare the half-effective concentration (ECe50) of remifentanil for insertion of laryngeal mask in target-controlled infusion (TCI) combined with different target concentration of propofol in Chinese women. Method Fifty female patients who were selected to schedule for mammary gland tumor excision surgery, were divided into 2 groups(n=25 in each group): group A: received propofol’s half-effective concentration at 3.0 μg/ml in Marsh model by TCI; group B: received propofol’s half-effective concentration at 4.0 μg/ml in Marsh model by TCI. All patients were given remifentanil in Minto model by TCI after being given propofol which reached the balance between effect-site concentration and blood plasma concentration. The target concentration of remifentanil was determined by a modification of Dixon's up-and-down method. Laryngeal mask insertion was attempted after 10 mins, the insertion condition and success rate were observed, then the suitable target concentration of remifentanil(ECe50) were calculated. Results There were no significant difference in age, weight, height and haemodynamic changes in two groups(P＞0.05). The ECe50 of remifentanil in group A was 2.89（95％CI 2.72～3.08）ng/ml. The ECe50 of remifentanil in group B was 1.58（95％CI 1.41～1.77）ng/ml. Conclusions In our study, the increasing dose of propofol could decrease the ECe50 of remifentanil.