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| 复合瑞芬太尼时艾司氯胺酮用于无痛胃镜诊疗麻醉诱导的半数有效剂量 |
| Median effective dose of esketamine combined with remifentanil in anesthesia induction of sedative gastroscopy |
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| DOI：10.12089/jca.2022.12.011 |
| 中文关键词: 序贯法 艾司氯胺酮 瑞芬太尼 无痛胃镜 |
| 英文关键词: Sequential method Esketamine Remifentanil Sedative gastroscopy |
| 基金项目:国家自然科学基金（82172190）；江苏省卫生健康委员会2021年度医学科研项目面上项目（166号）；扬州市创新能力建设计划专项基金（市级重点实验室培育）（YZ20211148） |
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| 中文摘要: |
目的 测定复合瑞芬太尼时艾司氯胺酮用于无痛胃镜诊疗麻醉诱导的半数有效剂量（ED50）。
方法 选择2021年10月于内镜中心行无痛胃镜诊疗的患者18例，男8例，女10例，年龄18～60岁，BMI 18～30 kg/m2，ASA Ⅰ或Ⅱ级。采用序贯法测定艾司氯胺酮用于无痛胃镜患者麻醉诱导的有效剂量，初始剂量为静脉推注艾司氯胺酮0.1 mg/kg复合瑞芬太尼0.3 μg/kg，艾司氯胺酮相邻药物剂量比值为1∶1.2，若患者MOAA/S评分≤1分、诱导时间≤2 min，体动程度≤1级且围麻醉期未发生Ⅲ级以上不良事件为镇静成功（成功组），则下一例患者在上一例的给药剂量基础上降低一个梯度，若任意一项指标不达标则为镇静失败（失败组），下一例给药剂量升高一个梯度；直到出现第7个拐点终止研究。采用Probit法计算艾司氯胺酮的ED50、95%有效剂量（ED95）及其95%可信区间（CI）。记录诱导时间和苏醒时间。
结果 艾司氯胺酮复合瑞芬太尼用于无痛胃镜诊疗麻醉诱导的ED50为0.215 mg/kg （95%CI 0.163～0.249 mg/kg），ED95为0.254 mg/kg （95%CI 0.227～0.453 mg/kg）。成功组诱导时间、苏醒时间明显短于失败组。
结论 艾司氯胺酮复合瑞芬太尼用于无痛胃镜麻醉诱导的ED50为0.215 mg/kg 。 |
| 英文摘要: |
Objective To measure median effective dose (ED50) of esketamine combined with remifentanil in anesthesia induction of sedative gastroscopy.
Methods Eighteen patients who received sedative gastroscopy in October 2021, 8 males and 10 females, aged 18-60 years, BMI 18-30 kg/m2, ASA physical status Ⅰ or Ⅱ , were selected. The induction dose of anesthesia according to the sequential method. The initial dose was intravenous injection of esketamine 0.1 mg/kg combined with remifentanil 0.3 μg/kg of adjacent drug dose ratio 1∶1.2. The patients with MOAA/S score ≤ 1, induction time ≤ 2 minutes, body movement degree ≤ 1, were considered as successful sedation (successful group), the induction dose of esketamine was increased in the next patient. If the patients with any index above fails to meet the standard, were considered as failure sedation (unsuccessful group). The number of samples was calculated as at least 7 reaction crossover points. The ED50, 95% effective dose (ED95) and 95% confidence interval (CI) were calculated using Probit method. Induction time and recovery time were recorded.
Results The ED50 of esketamine combined with remifentanil in anesthesia induction of sedative gastroscopy was 0.215 mg/kg (95% CI 0.163-0.249 mg/kg), and the ED95 was 0.254 mg/kg (95% CI 0.227-0.453 mg/kg). Induction time and recovery time in successful group were shorter than those in unsuccessful group.
Conclusion The ED50 of esketamine combined with remifentanil in anesthesia induction of sedative gastroscopy was 0.215 mg/kg. |
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