卵巢周期对患者入睡时异丙酚半数有效血浆靶浓度的影响.pdfVIP

卵巢周期对患者入睡时异丙酚半数有效 血浆靶浓度的影响 陆斌 吴安生 李军 目的评价卵巢周期对全麻患者入睡时异丙酚半数有效血浆靶浓度(EC50)的影响。 方法择期行妇科腹腔镜手术患者40例，ASA Ⅰ或Ⅱ级，年龄20-39(28.5±4.8)岁，根据孕酮含量 分为卵泡期组 （F组，血清孕酮浓度0.31-1.52ng/ml）和黄体期组(L组，血清孕酮浓度5.16-18.56 ng／ml)，每组20例。按序贯法采用Mash药代动力学参数靶控输注异丙酚，第1例患者血浆靶浓度 设为3.5μg/ml，相邻靶浓度比值为1.1。患者入睡为阳性反应，达到预期靶浓度后未入睡则为阴性 反应。计算入睡时异丙酚的EC50及其95%可信区间。结果 靶控输注异丙酚入睡时的EC50及其 95％可信区间分别为：F组4.76(4.52-5.00)μg/ml，L组4.18(3.88-4.52)μg/ml。与F组比较(t =6.23)，L组EC50降低(P＜0．Ol)。结论黄体期患者入睡时异丙酚半数有效血浆靶浓度低于卵 泡期患者。 月经周期；麻醉，全身；二异丙酚／药代动力学 Effectsofovariancycleonmedlan-effecttvetargetplasmaconcentrationofpropofolTCIcausedloss consciousness LUBin* WUAn-sheng LIJura *DepartmentofAnesthesiology,RuianPeoples Hospital,Ruian325200,China Objective Toevaluatetheeffectsofovariancycleonmedian-effectivetargetplasma concentration(EC50)ofpropofoladministeredbytargetcontrolledinfusion(TCI)causedlossconscious ness.Methods FortyASAIorIIpatientswhohadage20-39(28.5±4.8)yearsandwerescheduled forelectivegynecologiclaparoscopicsurgeryweredividedinto2groups(n=20eachgroup):Thefollicular phasegroup(Fgroup,serumprogesteroneconcentrationO.31 1.52ng/ml)andlutealphasegroup(L group,serumprogesteroneconcentration5.16～ 18.56ng/ral).Nopremedicationwasadministered.Propo folwasadministeredbyTCI.TCIsystemwasincorporatedwithMarshpharmacokineticmodel.EC50wasde terminedbyup-and-downsequentialtrial.Thetargetphsmaconcentration(Cp)wassetat3.5μg/mlin thefh-stpatientineachgroup.Eachtime,Cpwasincreased/decreasedby10％ inthenextpatientdepen dingonwhetherornotthelossconsciousnessoccurred.Results TheEChoand95％ confidenceintervalof propofolTCIcausedlossconsciousnesswere4.76(4.52-5.00)μg/mlingroupF,4.18(3.88～4.52) μg/mlingroupL.EC50ingroupLwassignificantlylowerthaningroupF(t=6.23,P＜0.01).Conclu sions Aslossconsciousnessoccurred,median-effectivetargetplasmaconcentrationofpropofolinluteal　 phasewaslowerthanthatinfollicularphase. Menstrualcycle;Anesthesia,general;Propofol/PK　 10.3760/ema.j.issn.1008-1372.2011.08