右美托咪定对七氟醚麻醉下小儿无肌松气管插管时瑞芬太尼半数有效血浆靶浓度影响.docVIP

右美托咪定对七氟醚麻醉下小儿无肌松气管插管时瑞芬太尼半数有效血浆靶浓度影响 　　[摘要] 目的 观察右美托咪定对七氟醚麻醉下小儿无肌松气管插管时瑞芬太尼半数有效血浆靶浓度（CP50）的影响。方法 择期全麻手术患儿51例，年龄3～6岁，ASAⅠ～Ⅱ级，随机分为右美托咪定组（D组，n=25）和对照组（C组，n=26）。D组和C组分别静脉输注右美托咪定0.5 μg/kg和生理盐水，吸入七氟醚维持呼气末浓度为2.7%，靶控输注瑞芬太尼，初始血浆靶浓度分别为3.5 ng/mL和4.0 ng/mL，相邻浓度梯度为0.5 ng/mL，采用序贯法进行试验，气管插管在效应室靶浓度和血浆靶浓度相同时进行。瑞芬太尼的CP50及95%可信区间（95%CI）采用Probit检验。结果 D组瑞芬太尼的CP50为3.34 ng/mL，其95%CI为2.77～3.82，C组瑞芬太尼的CP50为4.10 ng/mL，其95%CI为3.60～4.59，差异有统计学意义（P0.05）。 结论 复合2.7%七氟醚吸入麻醉下，静脉输注右美托咪定0.5 μg/kg可降低瑞芬太尼用于小儿无肌松气管插管的CP50。 　　[关键词] 右美托咪定；瑞芬太尼；插管法；气管内；剂量效应关系 　　[中图分类号] R726.1 [文献标识码] B [文章编号] 1673-9701（2015）09-0104-03 　　Effect of dexmedetomidine on half-effective target plasma concentration of remifentanil needed for tracheal intubation without neuromuscular relaxant in children when combined with sevoflurane inhalation 　　MO Liqun WU Gangming SONG Li 　　Department of Anesthesiology， the Affiliated Hospital of Luzhou Medical College， Luzhou 646000， China 　　[Abstract] Objective To investigate the effect of dexmedetomidine on half-effective target plasma concentration（CP50） of remifentanil needed for tracheal intubation without neuromuscular relaxant in children when combined with sevoflurane inhalation. Methods A total of 51 children aged 3-6 years old， ASAⅠ-Ⅱ undergoing elective surgery under general anesthesia were randomLy allocated into 2 groups： dexmedetomidine group （group D， n=25） and control group （group C， n=26）. In group D dexmedetomidine 0.5 μg/kg was infused while in group C equal volume saline was infused instead of dexmedetomidine. Sevoflurane was inhalated and the concentration was adjusted to 2.7% of end-tidal concenration. Remifentanil was administered by target-controlled infusion. Target plasma concentration of remifentanil was determined by up-and-down sequential trial. The initial target plasma remifentanil concentration was set at 3.5 ng/mL and 4.0 ng/mL in group D and group C. The gradient of two target plasma concentrations was 0.5 ng/mL. Tracheal intubation was performed afte