瑞芬太尼靶控输注对患者意识消失的丙泊酚效应室浓度的影响

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (8): 904-906.

瑞芬太尼靶控输注对患者意识消失的丙泊酚效应室浓度的影响

路志红, 董辉, 刘明富, 冯大鹏, 董海龙

第四军医大学西京医院麻醉科,西安 710032,陕西

收稿日期:2013-03-30 修回日期:2013-12-04 出版日期:2014-08-26 发布日期:2014-08-26
通讯作者: 董海龙,男,博士,副主任医师,副教授,主要从事全麻机制及围术期器官保护研究。 Tel: 029-84775343 E-mail: deerlufmmu@hotmail.com
作者简介:路志红,女,博士,讲师,主治医师,主要从事全麻机制及围术期器官保护研究。 Tel: 029-84775343 E-mail: deerlu23@163.com
基金资助:
国家自然科学基金(81070966); 陕西省社科攻关项目(2012SF2-01-6)

Effect site concentration of propofol for loss of consciousness under remifentanil target-controlled infusion

LU Zhi-hong, DONG Hui, LIU Ming-fu, FENG Da-peng, DONG Hai-long

Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi,China

Received:2013-03-30 Revised:2013-12-04 Online:2014-08-26 Published:2014-08-26

摘要/Abstract

摘要： 目的观察在瑞芬太尼靶控输注下,患者意识消失时丙泊酚的效应室浓度。方法全身麻醉患者分为瑞芬太尼+丙泊酚组(RP)和单纯丙泊酚组(P)。RP组给予瑞芬太尼靶控输注,待瑞芬太尼效应室浓度达到 4 ng/mL 时开始丙泊酚靶控输注,靶控输注浓度为血浆浓度 4 μg/mL。P组单纯按 4 μg/mL 给予丙泊酚靶控输注。记录患者意识消失时的丙泊酚效应室浓度。结果瑞芬太尼靶控输注下,令患者意识消失的丙泊酚效应室浓度ECe₅₀值为 0.84(0.75,0.93) μg/mL,ECe₉₅值为 1.40(1.27,1.59) μg/mL。单纯靶控输注丙泊酚则分别为 1.9(1.83,1.98) μg/mL 和 2.8(2.72,2.94) μg/mL。两组ECe₅₀值和ECe₉₅值均有统计学差异(P均<0.05)。RP组患者意识消失的时间和丙泊酚用量均明显低于P组,Narcotrend指数则高于P组,平均动脉压降低也较P组严重(P均<0.05)。结论瑞芬太尼可增强丙泊酚的镇静效果,降低令患者意识消失的丙泊酚效应室浓度。

关键词: 瑞芬太尼, 丙泊酚, 靶控输注, 意识消失, 效应室浓度

Abstract: AIM: To determine the influence of remifentanil on effect site concentration of propofol for loss of consciousness. METHODS: Patients scheduled for general anesthesia were randomly enrolled into group RP and group P. Group RP received target controlled infusion of remifentanil until an effect site concentration of 4 ng/mL was achieved. Then propofol was infused with a target plasma concentration of 4 μg/mL. Group P received infusion of propofol of the same target concentration. The effect site concentration of propofol for the patient losing consciousness was recorded.RESULTS: For the group RP, the ECe₅₀ of propofol effect site concentration for patients losing consciousness was 0.84(0.75,0.93) μg/mL,while the ECe₉₅ value was 1.40(1.27,1.59) μg/mL. However, for the group P, the ECe₅₀ value was 1.9(1.83,1.98) μg/mL and the ECe₉₅ value was 2.8(2.72,2.94) μg/mL. There were significant differences between the two groups considering both the two values (both P<0.05). Time to LOC and propofol needed to LOC was significantly lower in the RP group, while Narcotrend index was higher. Furthermore, the decrease of MAP was more significant in the RP group (all P<0.05).CONCLUSION: Remifentanil could increase the sedative effect of propofol and decrease the effect site concentration of propofol for loss of consciousness.

Key words: remifentanil, propofol, target controlled infusion, loss of consciousness, effect site concentration

中图分类号:

R969.2
R614

路志红, 董辉, 刘明富, 冯大鹏, 董海龙. 瑞芬太尼靶控输注对患者意识消失的丙泊酚效应室浓度的影响[J]. 中国临床药理学与治疗学, 2014, 19(8): 904-906.

LU Zhi-hong, DONG Hui, LIU Ming-fu, FENG Da-peng, DONG Hai-long. Effect site concentration of propofol for loss of consciousness under remifentanil target-controlled infusion[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(8): 904-906.

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