依托咪酯联合瑞芬太尼用于老年患者胃镜检查时依托咪酯的半数有效剂量

目的测定依托咪酯联合瑞芬太尼用于老年患者胃镜检查依托咪酯的ED50和ED95。方法选择行胃镜检查的老年患者23例,男13例,女10例,年龄65~78岁,体重45~76kg,ASAⅠ~Ⅲ级。预先缓慢静脉注射瑞芬太尼0.3μg/kg,然后注射依托咪酯0.20 mg/kg,待睫毛反射消失后行胃镜检查。依托咪酯的剂量采用改良序贯法确定,起始剂量为0.20 mg/kg,胃镜检查患者反应阳性标准:在整个检查过程中出现躁动、皱眉、吞咽、呛咳等。相邻间隔剂量为0.05 mg/kg,当出现七个交叉点终止研究。应用概率回归分析法计算依托咪酯复合瑞芬太尼老年患者胃镜检查的依托咪酯ED50和ED95及95%CI。结果依托咪酯ED50为0.17mg/kg,95%CI为0.14~0.21mg/kg,ED95为0.23mg/kg,95%CI为0.20~0.42mg/kg。结论依托咪酯联合瑞芬太尼用于老年患者无痛胃镜ED50、ED95分别为0.17mg/kg和0.23mg/kg。

Half-effective dosage of etomidate for combined remifentanil used in elderly patients in gastroscope

Objective To determine ED50 and ED9 5 of etomidate for combined remifentanil used in elderly patients in gastroscope.Methods Twenty-three patients were scheduled to receive gastros-copy aged 65-78 years old including males 13 and females 10,weighting 45-76 kg and ASA Ⅰ-Ⅲ. They were slowly injected remifentanil 0.3 μg/kg,and then etomidate 0.20 mg/kg,gastroscopy was performed after their eyelash reflex disappeared.The dosage of etomidate were determined by modified up-and-down methods,0.20 mg/kg was initial dosage.During the gastroscope,restlessness, frowning,swallowing,choking cough could be seen.The adjacent experimental interval dosage was 0.05 mg/kg,the trial was ended when there was the seventh cross-sectional,and determined the ED50 and ED9 5 of etomidate and (95%confidence interval)of them for gastroscope with probability a-nalysis methods.Results The ED50 of etomidate was 0.1 7 mg/kg and 95%CI 0.14-0.21 mg/kg,and the ED9 5 was 0.23 mg/kg,95%CI 0.20-0.42 mg/kg respectively.Conclusion The ED50 and ED9 5 of etomidate combined with remifentanil used for elderly patients for gastroscope respectively are 0.1 7 mg/kg and 0.23 mg/kg.