依托咪酯乳剂用于老年患者喉罩放置

目的探讨老年患者喉罩放置时依托咪酯乳剂的合适剂量。方法行择期喉罩全麻下手术的老年患者(年龄>65岁)75例,随机均分为五组:静注芬太尼1μg/kg后,分别静注依托咪酯乳剂0.2 mg/kg(Ⅰ组)、0.25 mg/kg(Ⅱ组)、0.3 mg/kg(Ⅲ组)、0.35 mg/kg(Ⅳ组)、0.4 mg/kg(Ⅴ组),固定由1名麻醉医师放置喉罩。放置喉罩时,患者出现吞咽、呛咳、屏气、喉痉挛等任何气道反应或肢体运动,均认为喉罩置入阳性反应。结果联合应用芬太尼1μg/kg,依托咪酯的50%有效剂量(ED50)为0.24 mg/kg(95%的可信区间为0.21~0.26 mg/kg),95%有效剂量(ED95)为0.35mg/kg(95%的可信区间为0.31~0.44 mg/kg)。结论依托咪酯乳剂0.35 mg/kg复合芬太尼1μg/kg静脉麻醉诱导用于老年患者喉罩放置,血流动力学稳定,不良反应少见。

Application of etomidate-lipuro for laryngeal mask airway insertion in elderly

Objective To determine the optimal dose of etomidate-lipuro required for the successful insertion of laryngeal mask airway(LMA) in the elderly. Methods Seventy-five patients aged greater than 65 years old scheduled for selective minor surgery were recruited. After fentanyl 1 μg/kg was administered intravenously, they were randomly received one of five dodges (0. 2,0. 25, 0. 3,0. 35 and 0. 4 mg/kg) of etomidate-lipuro. The successful insertion of LMA was defined as the absence of gross purposeful movement, coughing, gagging or laryngospasm after LMA insertion. Results Combined with fentanyl 1μg/kg, the ED_(50) and ED_(95) values of etomidate-lipuro for LMA insertion were 0. 24 mg/kg (95% confidence intervals, 0. 21-0. 26 mg/kg) and 0. 35 mg/kg (95% confidence intervals,0. 31-0. 44 mg/kg), respectively. Conclutsion Combined with fentanyl 1μg/kg, the optimum dose of etomidate-lipuro for LMA insertion in the elderly is 0. 35 mg/kg.