氟比洛芬酯对两种不同靶浓度瑞芬太尼输注下七氟醚MACBAR的影响

目的研究氟比洛芬酯对两种不同靶控浓度瑞芬太尼(1和3ng/mL)输注下七氟醚能抑制切皮时肾上腺素能反应的最低肺泡气浓度(MACBAR)的影响。方法 76例拟全麻行腹部手术患者随机分为4组:七氟醚+1ng/mL瑞芬太尼(A1组);七氟醚+1ng/mL瑞芬太尼+1mg/kg氟比洛芬酯(F1组);七氟醚+3ng/mL瑞芬太尼(A3组);七氟醚+3ng/mL瑞芬太尼+1mg/kg氟比洛芬酯(F3组)。采用改良序贯法进行实验,计算各组的七氟醚MACBAR,用概率单位回归分析计算各组七氟醚的ED50和ED95。结果 A1、F1组七氟醚的MACBAR分别为2.03%[95%置信区间(95%CI):1.9%～2.1%]和1.65%(95%CI:1.5%～1.9%),F1组较A1组减少18.8%,差异有统计学意义(P<0.01);A3、F3组七氟醚的MACBAR分别为0.4%(95%CI:0.2%～0.6%)和0.35%(95%CI:0.2%～0.4%),F3组较A3组减少12.5%,但差异无统计学意义(P>0.05)。结论瑞芬太尼效应室浓度1ng/mL靶控输注下,氟比洛芬酯可减低七氟醚MACBAR的18.8%;效应室浓度3ng/mL靶控输注下,其可减低七氟醚MACBAR的12.5%。

Effects of flurbiprofen axetil on sevoflurane MACBAR at two target-controlled concentrations of remifentanil

Objective To determine the effects of flurbiprofen axetil on the sevoflurane requirement for blunting adrenergic responses following surgical incision when sevoflurane combined with two different target-controlled concentrations of remifentanil(1 and 3 ng/mL).Methods A total of 76 patients,scheduled to undergoing general anaesthesia for elective abdominal surgery,were randomly allocated to receive sevoflurane anaesthesia alone(group A,n=41),or with the addition of flurbiprofen(group F,n=35).Patients of both groups were further assigned to receive a target-controlled effect-site concentration of 1 ng/mL(group A1,n=24;group F1,n=21),or 3 ng/mL remifentanil(group A3,n=17;group F3,n=14).Predetermined end-tidal sevoflurane concentrations and minimum alveolar concentration(MAC) for each group were determined using an up-and-down sequential allocation technique.Results All patients completed the study.The MAC of sevoflurane were 2.03% [95% confidence interval(95%CI):1.9%-2.1%] in group A1 and 1.65%(95%CI:1.5%-1.9%)in group F1(P<0.01),group F1 reduced it by 18.8% than group A1;while in groups A3 and F3 the MAC of sevoflurane were 0.4%(95%CI:0.2%-0.6%)and 0.35%(95%CI:0.2%-0.4%),respectively(P>0.05),group P3 reduces by 12.5%.Conclusion The addition of flurbiprofen axetil reduces the MAC of sevoflurane by 18.8% when using a remifentanil concentration of 1 ng/mL,and reduces 12.5% when using a remifentanil concentration of 3 ng/mL.