舒芬太尼静脉注射引起老年患者呼吸抑制的半数有效剂量.docVIP

舒芬太尼静脉注射引起老年患者呼吸抑制的半数有效剂量 　　[摘要] 目的 测定老年患者单独注射舒芬太尼或给予小剂量咪达唑仑时引起呼吸抑制的半数有效剂量（ED50）。方法 选择2014年10月～2015年10月于首都医科大学附属北京潞河医院择期拟行全麻腹部手术老年患者60例，年龄65～80岁。采用随机数字表法，将患者分为两组，每组各30例。S组给予单次静脉注射舒芬太尼，MS组先静脉注射咪达唑仑，5 min后再给予舒芬太尼。舒芬太尼剂量按序贯法确定，起始剂量分别为0.12 μg/kg和0.05 μg/kg，梯度剂量分别为0.01、0.005 μg/kg。MS组每例患者所用咪达唑仑的剂量为0.03 mg/kg。采用双盲法观察并记录患者的呼吸抑制情况，呼吸抑制的标准为SpO2≤92%和/或RR10次/min。计算舒芬太尼的ED50及其95%可信区间（CI）。 结果 S组致呼吸抑制的ED50为0.13 μg/kg，95%CI为0.125～0.139 μg/kg。MS组致呼吸抑制的ED50为0.06 μg/kg，95%CI为0.057～0.063 μg/kg。 结论 老年患者单次单纯静脉注射舒芬太尼导致呼吸抑制的ED50为0.13 μg/kg，舒芬太尼伍用咪达唑仑时引起呼吸抑制的ED50降为0.06 μg/kg。 　　[关键词] 舒芬太尼；咪达唑仑；呼吸抑制；半数有效剂量 　　[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210（2016）04（a）-0050-04 　　[Abstract] Objective To observe the median effective dose （ED50） of Sufentanil intravenous injection alone or combined with small dose of Midazolam for elderly patients. Methods 60 cases of elderly patients aged 65-80 underwent selected general anesthesia abdominal operation in Beijing Luhe Hospital， Capital Medical University from October 2014 to October 2015 were divided into two groups according to random number table， each group had 30 cases. Group S was given Sufentanil intravenous injection alone， group MS was given Midazolam intravenous injection firstly， 5 min later given Sufentanil. The dose of Sufentanil was determined by up-and-down sequential trail. The initial dose was set at 0.12 μg/kg and 0.05 μg/kg in group S and group MS respectively， the dosage gradient was 0.01， 0.005 μg/kg. The dose of Midazolam in group MS was 0.03 mg/kg. The respiratory depression situation was observed and recorded by double-blind method. The standard of respiratory depression was defined as SpO2 ≤ 92% and/or RR 10 times/min. ED50 and 95% confidence interval （CI） of respiratory depression was calculated. Results The ED50 and 95%CI of Sufentanil caused respiratory depression was 0.13 μg/kg and 0.125-0.139 μg/kg in group S respectively. The ED50 and 95%CI in group MS was 0.06 μg/kg and 0.057-0.063 μg/kg. Conclusion The ED50 of Sufe