置入ProSeal喉罩成人所需瑞芬太尼的半数有效剂量的测定

【目的】测定联合2．5mg／kg丙泊酚时，抑制ProSeal喉罩置入反应成人所需瑞芬太尼的半数有效量（ED50）。【方法】择期全麻手术患者，麻醉诱导使用丙泊酚与瑞芬太尼。先输注丙泊酚2．5mg／kg，60S后输注瑞芬太尼，在诱导开始150s后置入喉罩。瑞芬太尼的剂量按序贯法确定，起始剂量为0．5μg／kg，相邻剂量之间比率为1．2。喉罩置入后马上根据喉罩置入反应评估表进行评估，以喉罩置入反应评估为“差”时定义为喉罩置入阳性反应。入选样本从发生喉罩置入阳性反应的前一个病例开始，总数20例。【结果】瑞芬太尼抑制喉罩置入反应的半数有效剂量为0．19μg／kg，95％可信区间为0．17～0．20μg／kg。【结论】在复合2．5mg／kg丙泊酚时，瑞芬太尼抑制喉罩置入反应的半数有效剂量为0．19μg／kg。

Median Effective Dose of Remifentanil for ProSeal Laryngeal Mask Airway Insertion in Adults

Objective] To determine the median effective dose（ED50） of remifentanil combination with 2. 5mg/kg propofol for Progeal laryngeal mask airway insertion in adults. Methods] Patients undergoing elective surgery received anesthesia induction with propofol and remifentanil. Remifentanil was given at 60s after intravenous infusion of 2.5mg/kg propofol, and laryngeal mask airway was inserted at 150s after anesthesia induction. Remifentanil was given by ＂up and down＂ method. Initial dose was 0.5μg/kg, and the ratio between two close doses was 1.2. The response after inserting the ProSeal laryngeal mask airway was assessed. Positive reaction was defined when the patient＇s response was ＂bad＂. The samples were recruited from anterior positive reaction case and the amount was 20 cases. Results] The ED50 of remifentanil was 0.19μg/kg （95% confidence interval ranged from 0.17μg/kg to 0.20μg/kg） for inserting ProSeal laryngeal mask airway. Conclusion]The ED50 of remifentanil combination with 2.5mg/kg for inhibiting the response after inserting the ProSeal laryngeal mask airway is 0.19μg/kg.