不同靶浓度瑞芬太尼对老年患者异丙酚靶控输注半数效应室浓度的影响

目的：探讨不同效应室靶浓度瑞芬太尼对异丙酚靶控输注半数效应室浓度（ECe50）的影响。方法：择期静脉复合全麻下行经尿道前列腺电切术患者60例,年龄65～85岁,按瑞芬太尼效应室靶控浓度的不同随机分成3组,瑞芬太尼0.5 ng/ml（R0.5）;瑞芬太尼1.0 ng/ml（R1.0）;瑞芬太尼1.5 ng/ml（R1.5）,每组20例。达到效应室靶浓度后,按照序贯试验原则靶控输注（TCI）异丙酚,进电切镜出现体动反应,则下一例采用高一级浓度,反之,采用低一级浓度,各相邻浓度之间均为等比级数,比率为1.2。计算异丙酚ECe50及其95%可信区间（CI）。结果：R0.5组异丙酚的ECe50为2.37μg/ml,其95%可信区间为（2.22,2.53）,R1.0组异丙酚的ECe50为1.84μg/ml,95%可信区间为（1.75,1.94）,R1.5组异丙酚的ECe50为1.66μg/ml,95%可信区间为（1.60,1.71）。结论：增加瑞芬太尼靶浓度可降低异丙酚靶控输注浓度,但随着浓度增加,麻醉风险加大。

The effects of different effect-site target-controlled infusion concentration of remifentanil to the ECe50 Of propofol with target-controlled infusion in eldly patients

Objective： To investigate the effects of different target-controlled infusion concentration of remifentanil to the ECe50 of propofol with target-controlled infusion in eldly patients.Methods： Sixty patients aged 65-85,undergoing transurethral resection of prostate,were divided randomly into three groups（R0.5,R1.0,R1.5） with 20 cases each and given remifentanil with the target concentration of 0.5,1,1.5 ng/ml,respectively.Propofol was performed when remifentanil reached to the target concentration.Propofol was given by up and down method according to the movement of body and the ratio of two close effect concent rations was 1.2.Results： The ECe50 of the R0.5 group was 2.37 μg/ml.The 95% confidence interval was 2.22-2.53 μg/ml.The ECe50 of the R1.0 group was 1.84 μg/ml.The 95% confidence interval was 1.75-1.94 μg/ml.The ECe50 of the R1.5 group was 1.66 μg/ml.The 95% confidence interval was 1.60-1.71.Conclusion： The increasing of target-controlled infusion concentration of remifentanil help to decrease the ECe50 of propofol,but the danger of anesthesia will be bigger accordingly.