丙泊酚麻醉下舒芬太尼抑制病人气管插管-第三军医大学学报.doc

丙泊酚麻醉下舒芬太尼抑制气管插管 反应的半数有效浓度 钱晓岚1 张卫阚全程【摘要】定异丙酚靶控输注时芬太尼抑制气管插管反应的半数有效浓度(Ce50)。择期手术病人，靶控输注芬太尼靶浓度按序贯法确定，相邻靶浓度之间比率为1．2芬太尼抑制气管插管反应的Ce50为95％可信区间为在复合靶控输注3时，芬太尼抑制气管插管反应的Ce50为。【关键词】 QIAN Xiao-lan, , .Department of Anesthesiology,The Third People Hospital of Henan Province .ZHANG Wei, KAN Quan-cheng，.Department of Anesthesiology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052 ,China 【Abstract】 Objective To determine the half-effective target effect-site concentration(Ce50) of sufentanil blunting cardiovascular responses to tracheal intubation during propofol administration.Methods ASA class Ⅰ-Ⅱ patient aged 30-50 yr with body weight index ﹤30kg/m2 undergoing elective surgery under general anesthesia? were enrolled in this study. Induction of anesthesia was initiated by TCI of sufentanil at the target concentration with the Bovill model.3 minite latter, TCI of propofol at the target plasma concentration of 3μg/ml.began .After the loss of consciousness,vecuronium 0.1mg/kg was administrated.Target effect-site concentration of sufentanil was determined by up and down sequential test,The initial concentration was set at 0.4ng/ml.The ratio of two successive target effect-site concentration was1.2.Cardiovascular responses were defined as an increase in MAP≥15% and/or HR＞90/min within 2 min after intubation. Results The Ce50 of sufentanil was 0.32ng/ml .95% confidence interval was between 0.3ng/ml and0.36ng/ml. Conclusion The Ce50 of sufentanil blunting cardiovascular responses to tracheal intubation is 0.32ng/ml during propofol anesthesia and 95% confidence interval is between 0.3ng/ml and 0.36ng/ml. 【Key words】Piperidines;Intubation,intratracheal;Drug delivery systems;Dose-response relationship,drug;Propofol 减轻气管插管时的应激反应是维持全麻平稳的重要环节。研究显示舒芬太尼可维持患者气管插管过程中的血液动力学稳定[1]，适用于全麻诱导中。但靶控輸注舒芬太尼抑制气管插管反应的量效关系尚无定论。本研究拟探讨丙泊酚麻醉下舒芬太尼抑制气管插管反应的半数有效浓度Ce50)。）））Ce50的对数值：㏒Ce50=∑n㏒X/∑n Ce50的对数值的标准误：SCe50=i 总体Ce50的95%可信区间的对数值：（㏒Ce50＋1.96S㏒Ce50，㏒Ce50－1.96S㏒C