右美托咪啶对瑞太尼抑制下腹部手术患者切皮时体动反应半数有效效应室靶浓度的影响.pdfVIP

万方数据 右美托咪啶对瑞芬太尼抑制下腹部手术患者切皮时体动反应半 数有效效应室靶浓度的影响 摘要 目的：评价右美托咪啶对瑞芬太尼抑制下腹部手术患者体动反应的半数有效效应室 靶浓度(EC )的影响. 50 方法：择期行子宫全切术或子宫肌瘤剜除术患者,ASA分级I或II 级，年龄20-60 岁，体重指数20-30kg/m2,采用随机数字表法，将患者随机分为2组，D组静脉输注 右美托咪啶0.6µg/kg,时间设定为10min,C组给予生理盐水，停药5min时开始靶控 输注异丙酚，血浆靶浓度3. 0µg/ml，输注12min时，2组开始靶控输注瑞芬太尼， 第1例的效应室靶浓度为4.5ng/ml，输注瑞芬太尼3min时置入喉罩，保留自主呼 吸，待瑞芬太尼达到目标靶浓度后开始手术。根据切皮时是否发生体动反应确定下 一例患者瑞芬太尼的靶浓度，相邻靶浓度比值为1.2.采用序贯法计算瑞芬太尼抑制 切皮时体动反应的EC50 及其95%可信区间（95%CI）。 结果：D组和C组样本数分别为18和20.瑞芬太尼抑制切皮时体动反应的EC50 分别 为1.23 ng/ml(95%CI 1.16-1.30 ng/ml)和1.52 ng/ml(95%CI 1.44-1.60 ng/ml)， D组比C组降低19%（P0.05。 结论：术前静脉注射右美托咪啶0.6µg/kg可降低瑞芬太尼抑制下腹部手术患者切皮 时体动反应的EC50，大约降低 19 %。 关键词：右美托咪啶；瑞芬太尼；剂量效应关系；药物；体动反应 万方数据 Effect of dexmedetomidine on median effective target effect-site concentration of refentanil inhibiting bdy movement evoked by skin incision inpatients undergoing abdominal surgryAbstract Objective: To investigate the effect of dexmedetomidine on median effective target effect-site concentration(EC50) of refentanil inhibiting body movement evoked by skin incision in patients undergoing abdominal surgery. Methods:Thirty-eight ASA I or II patients of both 20-60 yr with a body mass index of 20-30kg/m2 undergoing abdominal surgery were randomly divided into 2 groups:control group(group C) and dexmedetomidine group(group D).The patients were premedicated with intramuscular phenobarbital 0.1g and scopolamine 0.3mg.In group D dexmedetomidine 0.6µg/kg was injected iv over 10min at 5min before induction of anesthesia .Anesthesia was induced with target-controlled infusion(TCI) of propofol and refentanil.The target plasma concentration of propofol was set a 3.oµg/ml .TCI of refentanil was started at 12m