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中国临床药理学与治疗学 ›› 2020, Vol. 25 ›› Issue (9): 1033-1037.doi: 10.12092/j.issn.1009-2501.2020.09.011

• 药物治疗学 • 上一篇    下一篇

复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的半数有效血浆靶浓度

杨沁岩,黄立,石岚,欧媛媛,黎国媛,黄成勇   

  1. 重庆市第七人民医院麻醉科,重庆 400054
  • 收稿日期:2020-04-22 修回日期:2020-06-28 出版日期:2020-09-26 发布日期:2020-09-30
  • 作者简介:杨沁岩,男,硕士,主任医师,研究方向:麻醉药理及并发症。 Tel: 13658336734 E-mail: 1521969551@qq.com
  • 基金资助:
    重庆市科卫联合医学科研项目(2019QNXM009);重庆市巴南区科技计划项目(2019SHSY524)

Median effective plasma concentration of propofol inhibiting body movement when combined with butorphanol in patients undergoing hysteroscopic surgery 

YANG Qinyan, HUANG Li, SHI Lan, OU Yuanyuan, LI Guoyuan, HUANG Chengyong   

  1. Deparrment of Anesthesiology, Chongqing Seventh People's Hospital, Chongqing 400054, China 
  • Received:2020-04-22 Revised:2020-06-28 Online:2020-09-26 Published:2020-09-30

摘要: 目的:确定复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的半数有效血浆靶浓度(Cp50)。方法:选择21例拟行宫腔镜手术患者,年龄20~55岁,ASA Ⅰ或Ⅱ级。麻醉采用非插管静脉麻醉,麻醉诱导采用靶控输注丙泊酚,当血浆靶浓度和效应室靶浓度达平衡时方可宫腔镜手术操作,手术操作前5 min静脉缓慢注射酒石酸布托啡诺20 μg/kg。监测麻醉不同时点的麻醉深度及不良反应。采用序贯法确定丙泊酚血浆靶浓度(Cp),第1例患者丙泊酚血浆Cp设为2.5 μg/mL,手术中发生体动时为阳性,下一例采用高一级浓度,否则采用低一级浓度,浓度的比值为1∶1,根据结果将患者分为阳性和阴性组。用序贯法公式计算复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的Cp50及其95%CI。结果:复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的Cp50及其95%CI为2.23(2.12~2.34)μg/mL。所有患者均未发生严重不良反应。结论:复合20 μg/kg布托啡诺时丙泊酚抑制宫腔镜手术患者体动的Cp50为2.23 μg/mL,为宫腔镜手术麻醉安全用药提供参考。

关键词: 丙泊酚, 布托啡诺, 宫腔镜手术, 半数有效血浆靶浓度

Abstract: AIM: To determine the median effective plasma concentration (Cp50) of propofol inhibiting body movement when combined with butorphanol in patients undergoing hysteroscopic surgery. METHODS: Twenty-one patients scheduled for elective hysteroscopic surgery under non-intubated intravenous anesthesia, age 20-55 years old, ASA physical status Ⅰ or Ⅱ, were enrolled in this study, and anesthesia was induced by target-controlled infusion of propofol. Hysteroscopy was performed only when the plasma concentration and the concentration of the effector chamber were balanced. Butorphanol 20 μg/kg was injected intravenously at 5 min before surgery. The depth of anesthesia and adverse reactions during anesthesia was monitored. The plasma target concentration (Cp) of propofol was determined by up-and-down method, the first patient was 2.5 μg/mL, each time Cp increased/decreased by 10% in the next patient depending on whether or not body movement occurred. The patients were divided into positive and negative groups according to the results. The Cp50 and 95% confidence inlerval (CI) of propofol inhibiting body movement were calculated by up-and-down formula when combined with butorphanol in patients undergoing hysteroscopic surgery. RESULTS: The Cp50(95%CI) of propofol required to inhibit body movement was 2.23(2.12-2.34) μg/mL when combined with butorphanol in patients undergoing hysteroscopic surgery. None of the patients had serious adverse reactions. CONCLUSION: The Cp50 of propofol required to inhibit body movement is 2.23 μg/mL when combined with 20 μg/kg butorphanol in patients undergoing hysteroscopic surgery. It provides a reference for safe dosage of anesthesia in hysteroscopic surgery.

Key words: propofol, butorphanol, hysteroscopic surgery, median effective plasma concentration

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