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

发布时间：2018-03-22 06:27

本文选题：右美托咪定　切入点：丙泊酚　出处：《临床麻醉学杂志》2017年02期 　论文类型：期刊论文

【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(Ce_(50))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,ASAⅠ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0.8ng/ml的血浆靶浓度靶控输注右美托咪定15min,然后以初始效应室靶浓度(Ce)1.0μg/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0.2μg/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Ce50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Ce50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,P0.01)。与P、D1和D2组比较,D3组心动过缓的发生率明显增加(P0.05)。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_(50)逐渐降低。靶控输注右美托咪定0.4或0.6ng/ml能明显降低丙泊酚致意识消失Ce50,心动过缓发生率较低,适合辅助丙泊酚进行麻醉诱导。
[Abstract]:Objective to observe the effect of target-controlled infusion of dexmetomidine on propofol induced by propofol in patients with disappearance of consciousness. Methods 64 patients (28 males and 36 females) undergoing selective laryngeal mask general anesthesia were selected. Aged 20 to 60 years with ASA I or II, They were randomly divided into four groups: blank group (n = 16), control group (n = 16), control group (n = 16), control group (n = 16), control group (n = 16), control group (n = 16), control group (n = 16), control group (n = 16), group D _ 1 with low concentration of dexmetomidine, group D _ 2 with a medium concentration of dextromidine (n = 16) and group D _ 3 (n = 16). The target controlled infusion of dexmetomidine was performed for 15 minutes, and then propofol was injected with the initial target concentration of 1. 0 渭 g/ml. The target concentration of propofol was gradually increased by 0. 2 渭 g/ml each time the concentration of propofol was balanced with the target concentration of propofol, and the target concentration of propofol was increased gradually at 0. 2 渭 g/ml. The Ce50 and 95 CI of propofol were observed and calculated when the consciousness of the patient disappeared, and the adverse reactions during anesthesia induction were observed. Results the Ce50 and its 95%CI of propofol induced by propofol in group D _ 2 and D _ 3 were 2.921.871.961.601.551.65) 渭 g / ml and 1.45 渭 g / ml, respectively. There was a negative correlation between the effect chamber concentration induced by propofol and the plasma target concentration of dexmetomidine. The incidence of bradycardia in group D _ 3 was significantly higher than that in group D _ 1 and D _ 2.Conclusion with the increase of plasma target concentration of dexmetomidine, the incidence of bradycardia in group D _ 3 is significantly higher than that in group D _ 2. Target controlled infusion of dexmetomidine 0.4 or 0.6ng/ml could significantly reduce the consciousness disappearance of propofol induced by propofol, and the incidence of bradycardia was lower, so it was suitable to assist propofol anesthesia induction.
【作者单位】：广州医科大学;广州军区广州总医院麻醉科;
【基金】：广东省科技计划项目(2014A020215026) 军队后勤科研计划面上项目(CGZ15C003)
【分类号】：R614

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