右美托咪定滴鼻用于患儿面罩吸入麻醉诱导前镇静的半数有效量 |
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引用本文: | 纪宏新,何世琼,陈文,毕莹,李安学. 右美托咪定滴鼻用于患儿面罩吸入麻醉诱导前镇静的半数有效量[J]. 国际麻醉学与复苏杂志, 2016, 0(1): 6-9. DOI: 10.3760/cma.j.issn.1673-4378.2016.01.002 |
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作者姓名: | 纪宏新 何世琼 陈文 毕莹 李安学 |
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作者单位: | 深圳市龙岗区人民医院麻醉科,518172 |
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基金项目: | 深圳市卫生计生系统科研项目 |
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摘 要: | 目的 测定右美托咪定(dexmedetomidine,Dex)滴鼻用于患儿面罩吸入麻醉诱导前镇静的ED50,比较幼儿、学龄前和学龄患儿ED50的差异. 方法 选择ASA分级Ⅰ、Ⅱ级接受面罩吸入麻醉诱导的患儿,按年龄分为幼儿组(1~3岁)、学龄前组(4~6岁)和学龄组(7~12岁),每组预计35例.每组均在麻醉前1h经鼻滴入Dex,起始剂量为2μg/kg,按改良序贯法进行调整,根据上一例患儿面罩吸入诱导时的镇静满意程度,下一例患儿增加或减少0.25 μg/kg.镇静效果以面罩接受程度四分法进行评估,1~2分为镇静不满意,3~4分为镇静满意.用概率单位回归分析法计算出Dex满意镇静的ED50及相应的95%置信区间(95%CI). 结果 幼儿组、学龄前组和学龄组实际所需例数分别为31、28和30.幼儿组、学龄前组和学龄组Dex滴鼻镇静的ED50和95%CI分别为1.94(1.72~2.18)、1.61(1.41~1.82) μg/kg和1.30(1.13~1.47) μg/kg,3组间比较,差异有统计学意义(P<0.05). 结论 随着患儿年龄的增加,面罩吸入麻醉诱导前所需Dex滴鼻镇静的ED50减小.
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关 键 词: | 右美托咪定 鼻腔给药 吸入诱导 小儿 镇静 半数有效量 |
The median effective dose of intranasal dexmedetomidine sedation for acceptance of mask inhalation anesthesia induction in children |
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Abstract: | Objective To determine the ED50 of intranasal dexmedetomidine(Dex) sedation for acceptance of mask inhalation anesthesia induction in children,and to compare the difference of ED50 among infants,preschool and school-age children.Methods ASA physical status Ⅰ or Ⅱ children,scheduled for mask inhalation anesthesia induction,were allocated into 3 groups according to age:infant group(1-3 y),preschool group(4-6 y) and school-age group(7-12 y),and the case number expectation for each group is 35.Every child was titrated Dex into nostril 1 h before inhalational induction,and the initial dose of Dex was set at 2 μg/kg.Using the modified Dixon's up-and-down method depending on the sedation effect of the previous child,the dose of Dex in the next child was increased or decreased by 0.25 μg/kg.The tolerant degree of face mask was evaluated using a different 4-point scale.1-2 scores were considered as unsatisfactory and 3-4 scores were considered as satisfactory.Probit analysis was used for calculating ED5o and 95% confidence interval (CI) of intranasal Dex sedation.Results 31,28 and 30 cases were practically used in infant group,preschool group and school-age group,respectively.The ED50 of Dex for intranasal sedation was 1.94 μg/kg in infant group (95%CI:1.72-2.18 μg/kg),1.61 μg/kg in preschool group (95%CI:1.41-1.82 μg/kg),and 1.30 μg/kg in school-age group (95%CI:1.13-1.47 μg/kg),respectively.The ED50 among the three groups have significant difference (P<0.05).Conclusions The ED50 of Dex required for intranasal sedation before mask inhalation anesthesia induction is decreased followed by the increase of age in children. |
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Keywords: | Dexmendetomidine Intranasal administration Inhalational induction Children Sedation Median effective dose |
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