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| 靶控输注右美托咪定对丙泊酚致意识消失效应室半数有效浓度的影响 |
| Effects of target-controlled infusion of dexmedetomidine on the median effective concentration of effect-site of propofol at loss of consciousness |
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| DOI： |
| 中文关键词: 右美托咪定 丙泊酚 意识消失 靶控输注 效应室半数有效浓度 |
| 英文关键词: Dexmedetomidine Propofol Loss of consciousness Target-controlled infusion Median effective concentration of effect-site |
| 基金项目:广东省科技计划项目（2014A020215026）;军队后勤科研计划面上项目(CGZ15C003) |
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| 中文摘要: |
| 目的 观察静脉靶控输注（target-controlled infusion,TCI）右美托咪定对丙泊酚致患者意识消失效应室半数有效浓度(Ce50)的影响。方法 选择择期行喉罩全麻下手术患者64例，男28例，女36例，年龄20～60岁，ASA Ⅰ或Ⅱ级,随机分为四组:空白组(P组)、低浓度右美托咪定组(D1组)、中浓度右美托咪定组(D2组)和高浓度右美托咪定组(D3组)，每组16例。麻醉诱导时分别以0、0.4、0.6和0.8 ng／ml的血浆靶浓度靶控输注右美托咪定15 min,然后以初始效应室靶浓度（Ce）1.0 μg／ml靶控输注丙泊酚。每次待丙泊酚的效应室浓度与靶浓度平衡时以0.2 μg／ml逐步升高丙泊酚的靶浓度,直至患者意识消失。观察和计算患者意识消失时丙泊酚的Ce[sub]50[/sub]及其95%CI，观察麻醉诱导过程中不良反应情况。结果 P、D1、D2和D3组丙泊酚致意识消失Ce[sub]50[/sub]及其95％CI分别为2.30(2.24～2.36)、1.92(1.87～1.96)、1.60(1.55～1.65)和1.41(1.35～1.45) μg／ml。丙泊酚致意识消失的效应室浓度与右美托咪定的血浆靶浓度呈负相关关系(r=-0.84,P＜0.01)。与P、D1和D2组比较,D3组心动过缓的发生率明显增加(P＜0.05)。结论 随着右美托咪定血浆靶浓度的升高,丙泊酚致意识消失Ce[sub]50[/sub]逐渐降低。靶控输注右美托咪定0.4 或0.6 ng／ml能明显降低丙泊酚致意识消失Ce[sub]50[/sub],心动过缓发生率较低,适合辅助丙泊酚进行麻醉诱导。 |
| 英文摘要: |
| Objective To investigate the effects of target-controlled infusion (TCI) of dexmedetomidine on the median effective concentration of effect-site (Ce50) of propofol at loss of consciousness (LOC) in patients. Methods Sixty-four patients, 28 males and 36 females, aged 20-60 years, ASA physical status Ⅰ or Ⅱ, scheduled for elective surgery, were randomly allocated to receive dexmedetomidine of 0 ng／ml (group P), dexmedetomidine of 0.4 ng／ml (group D1), dexmedetomidine of 0.6 ng／ml (group D2) and dexmedetomidine of 0.8 ng／ml (group D3) for 15 min before TCI of propofol, n=16 in each group. The propofol infusion was started to provide an effect-site concentration of 1.0 μg／ml, and increased by 0.2 μg／ml when propofol effect-site concentration and target concentration were equilibrium until LOC. Results The Ce50 (95％CI) at loss of consciousness in groups P, D1, D2 and D3 were 2.30 (2.24-2.36) μg／ml, 1.92 (1.87-1.96) μg／ml, 1.60 (1.55-1.65) μg／ml and 1.41 (1.35-1.45) μg／ml, respectively. There was a negative correlation between the effect-site concentration of propofol-induced LOC and target concentration of dexmedetomidine (r=-0.84, P＜0.01). Compared with groups P, D1 and D2, the incidence of bradycardia was higher in group D3 (P＜0.05). Conclusion The Ce50 of propofol-induced LOC gradually decreases with increasing target concentration of dexmedetomidine. Combining propofol with dexmedetomidine of 0.4 or 0.6 ng／ml that can reduce the Ce50 of propofol-induced LOC, which is suitable for induction of anesthesia with a lower incidence of bradycardia. |
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