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| 无痛胃镜检查时丙泊酚对羟考酮有效剂量的影响 |
| Effective dose of oxycodone during painless gastroscopy with different doses of propofol |
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| DOI：10.12089/jca.2019.08.007 |
| 中文关键词: 无痛胃镜 羟考酮 丙泊酚 药效学 保守回归法 |
| 英文关键词: Painless gastroscopy Oxycodone Propofol Pharmacodynamics Conservative regression analysis |
| 基金项目: |
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| 中文摘要: |
目的 采用保守回归法评价无痛胃镜检查时不同丙泊酚浓度对羟考酮半数有效剂量（ED50）的影响。
方法 无痛胃镜检查患者65例，男35例，女30例，年龄18~60岁，BMI 20~24 kg/m2，ASA Ⅰ或Ⅱ级，采用随机数字表法将患者随机分为两组。A组和B组丙泊酚TCI血浆浓度分别为5 μg/ml和3 μg/ml，首例患者羟考酮初始剂量分别为0.07 mg/kg和0.1 mg/kg。根据前一例患者无痛胃镜置入结果决定次例患者羟考酮剂量。前一例患者体动或呛咳反应阳性，则下一例患者羟考酮剂量增加0.01 mg/kg，反之减少0.01 mg/kg。采用保守回归法计算羟考酮的ED50及其95%可信区间（95%CI），重复样本法计算ED95及其95%CI。记录入镜时吞咽、呛咳、体动发生情况；记录麻醉后低血压和低血氧情况；记录术后恶心、呕吐等不良反应情况。
结果 A组羟考酮ED50为0.074 mg/kg（95% CI 0.063~0.086 mg/kg），ED95为0.100 mg/kg（95%CI 0.087~0.194 mg/kg）。B组羟考酮ED50为0.086 mg/kg（95%CI 0.061~0.098 mg/kg），ED95为0.118 mg/kg（95%CI 0.103~0.308 mg/kg）。A组低血压发生率明显高于B组（P<0.05）。两组恶心和呕吐发生率差异无统计学意义。
结论 丙泊酚TCI血浆浓度5.0 μg/ml和3.0 μg/ml时，羟考酮的ED95分别为0.100 mg/kg和0.118 mg/kg。 |
| 英文摘要: |
Objective To evaluate effective dose of oxycodone during painless gastroscopy with different doses of propofol.
Methods Sixty-five patients undergoing painless gastroscopy, 35 males and 30 females, aged 18-60 years, BMI 20-24 kg/m2, ASA physical status Ⅰ-Ⅱ, were divided into two groups by random number table method. The plasma target concentration infusion of propofol TCI in group A and group B were 5 μg/ml and 3 μg/ml, respectively. The initial doses of oxycodone in group A and group B were 0.07 mg/kg and 0.1 mg/kg, respectively. The dose of oxycodone in the latter patient was determined according to the results of former patient. If the former patient is positive, the dose of oxycodone in the next patient will be increased by 0.01 mg/kg, and vice versa. Finally, conservative regression analysis was used to obtain the results.
Results The ED50 of oxycodone in group A and group B were 0.074 mg/kg (95% CI 0.063-0.086 mg/kg) and 0.086 mg/kg (95% CI 0.061-0.098 mg/kg), respectively. Oxycodone ED95 in group A and group B were 0.100 mg/kg (95% CI 0.087-0.194 mg/kg) and 0.118 mg/kg (95% CI 0.103-0.308 mg/kg), respectively. Compared with group B, the incidence of hypotension in group A was higher(P < 0.05). There was no difference in the incidence of nausea and vomiting between the two groups.
Conclusion The ED95 of propofol 5.0 μg/ml and 3.0 μg/ml are 0.100 mg/kg and 0.118 mg/kg, respectively. |
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