右美托咪定联合瑞芬太尼用于中期妊娠引产术患者镇静的ED50

发布时间：2018-06-03 09:18

  本文选题：右美托咪定 + 瑞芬太尼　； 参考：《河北医科大学》2017年硕士论文

【摘要】：目的:探索右美托咪定复合瑞芬太尼在中期妊娠患者引产术镇静的最小有效剂量,旨在为右美托咪定在中期妊娠引产术中的应用提供合理依据,以确保产妇在引产过程中的安全性。方法:选择年龄18-45岁,ASA I或II级的产妇参加本实验。当产妇进入产房后,常规监测心率、无创血压、脉搏血氧饱和度、呼吸频率、BIS值。对所有产妇给予面罩持续吸氧(氧流量2-3L/min),开放上肢静脉通道。给予瑞芬太尼负荷剂量0.5μg/kg,持续泵注剂量0.05μg/kg/min,同时泵注右美托咪定,初始剂量0.2μg/kg/h,给药后26分钟评估产妇的镇静深度,通过改良序贯法来确定右美托咪定的剂量,若上一例产妇意识抑制阳性,则下一例产妇药物剂量减少0.05μg/kg/h,反之增加0.05μg/kg/h,直至研究结果出现7个意识抑制阴性转阳性的转折点,研究结束。意识抑制阳性定义为:睫毛反应消失,Ramsay评分4级,BIS值≤70。结果:共有26例产妇参加研究,右美托咪定用于中期妊娠引产患者出现意识抑的ED50、ED95及其95%CI分别为0.39μg/kg/h(0.32~0.61μg/kg/h)、0.62μg/kg/h(0.48~1.95μg/kg/h)。结论:右美托咪定复合瑞芬太尼用于中期妊娠引产术患者镇静的半数有效剂量为0.39μg/kg/h。
[Abstract]:Objective: to explore the minimum effective dose of dexmetomidine combined with remifentanil in the sedation of induced labor in the second trimester of pregnancy, so as to provide a reasonable basis for the application of dexmetomidine in the induction of labor in the second trimester. To ensure the safety of pregnant women during induction of labor. Methods: women aged 18-45 years with ASA I or II were enrolled in this study. Heart rate, noninvasive blood pressure, pulse oxygen saturation, respiratory frequency and BIS value were routinely monitored when the parturient entered the labor room. All parturients were given continuous oxygen inhalation (oxygen flow rate 2-3 L / min), opening of upper limb venous passage. The loading dose of remifentanil was 0.5 渭 g / kg, the continuous dose was 0.05 渭 g / kg / min, and the initial dose was 0.2 渭 g / kg / h. 26 minutes after administration, the depth of sedation was evaluated, and the dose of dexmetomidine was determined by the modified sequential method. If the last case was positive for consciousness inhibition, the next case had a decrease in drug dose of 0.05 渭 g / kg / h, whereas an increase of 0.05 渭 g / kg / h, until the results of the study showed 7 turning points of negative to positive of consciousness inhibition. Consciousness inhibition positive is defined as: eyelash response disappeared and Ramsay score grade 4 and BIS 鈮，

本文编号：1972263