实用医学杂志 ›› 2021, Vol. 37 ›› Issue (10): 1284-1287.doi: 10.3969/j.issn.1006⁃5725.2021.10.010

• 临床研究 • 上一篇    下一篇

序贯法测定丙泊酚复合瑞芬太尼用于小儿无肌松气管插管的有效剂量

谭美云赵秉诚, 刘克玄   

  1. 南方医科大学南方医院麻醉科(广州 510515)
  • 出版日期:2021-05-25 发布日期:2021-05-25
  • 通讯作者: 刘克玄 E⁃mail:liukexuan705@163.com
  • 基金资助:
    中国博士后科学基金(编号:2019M662976)

A study for the effective dose of propofol combined with remifentanil for the endotracheal intubation with⁃ out muscle relaxants in children by sequential method 

TAN Meiyun,ZHAO Bingcheng,LIU Kexuan.    

  1. Depart⁃ ment of Anesthesiology,Nanfang Hospital,Southern Medical University,Guangzhou,Guangdong 510515,China 
  • Online:2021-05-25 Published:2021-05-25
  • Contact: LIU Kexuan E⁃mail:liukexuan705@163.com

摘要:

目的 采用序贯法分阶段分别测定丙泊酚复合瑞芬太尼用于小儿无肌松气管插管中的半 数有效剂量(median effective dose,ED50)及 95%有效剂量(95 % effective dose,ED95)。方法 选择择期手术患儿 70 例,年龄 1 ~ 3 岁,ASAⅠ或Ⅱ级,分阶段进行序贯试验。第一阶段固定丙泊酚诱导剂量 3.5 mg/kg,测瑞芬太尼 ED50、ED95;第二阶段固定瑞芬太尼 ED95,测丙泊酚 ED50、ED95。用 probit 概率单位法计算 ED 95%CI结果 瑞芬太尼 ED50 2.50(1.91,3.28)μg/kg、ED95 3.91(3.19,9.53)μg /kg;丙泊酚 ED50 2.34(1.73 2.94)mg/kg、ED95 3.67(3.02,8.65)mg/kg。结论 丙泊酚复合瑞芬太尼可安全用于 1 ~ 3 岁小儿无肌松气管 插管,丙泊酚ED50、ED95,瑞芬太尼ED50、ED95可为临床提供精准用药依据。

关键词:

丙泊酚, 瑞芬太尼, 有效剂量, 无肌松气管插管

Abstract:

Objective The purpose of this study was to determine the median and 95 percent effective doses (ED50,ED95)of propofol and remifentanil for endotracheal intubation without muscle relaxant in pediatric patients using a sequential method. Methods In two stages,70 children undergoing elective surgery were chosen for the sequential trial. In the first stage,the induction dose of propofol was fixed at 3.5 mg/kg,and the ED50 and ED95 of remifentanil were measured. In the second stage,the ED95 of remifentanil was fixed,and the ED50 and ED95 of pro⁃ pofol were measured. Using the probit probability unit process,the ED and 95 percent confidence interval(CI were measured. Results The ED50 of remifentanil was 2.50(95%CI 1.91,3.28)μg/kg,and the ED95 was 3.91 (3.19,9.53)μg/kg. The ED50 of propofol was 2.34(1.73,2.94)mg/kg,and the ED95 was 3.67(3.02,8.65)mg/kg. Conclusions Propofol and remifentanil can be used safely in children aged 1 to 3 years old for endotracheal intu⁃ bation without the use of a muscle relaxant.Propofol and remifentanil have ED50 and ED95 values that can be used as a guide for specific drug administration。

Key words:

propofol, remifentanil, effective dose, endotracheal intubation without muscle relaxants in children