[1]曹培雨,刘功俭*.右美托咪定对可视喉镜气管插管时芬太尼抑制插管反应半数有效量的影响[J].徐州医科大学学报,2017,37(07):428-431.
　CAO Peiyu,LIU Gongjian*.Effects of dexmedetomidine on the median effective dose of fentanyl to prevent endotracheal intubation response using visual laryngoscopy[J].Journal of Xuzhou Medical University,2017,37(07):428-431.
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右美托咪定对可视喉镜气管插管时芬太尼抑制插管反应半数有效量的影响()
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《徐州医科大学学报》[ISSN:2096-3882/CN:32-1875/R]

卷:
37
期数:
2017年07期
页码:
428-431
栏目:
出版日期:
2017-07-25

文章信息/Info

Title:
Effects of dexmedetomidine on the median effective dose of fentanyl to prevent endotracheal intubation response using visual laryngoscopy
作者:
曹培雨1; 刘功俭2*
1.徐州医科大学研究生学院，江苏徐州221004；2.徐州医科大学附属医院麻醉科，江苏徐州221002
Author(s):
 CAO Peiyu1;  LIU Gongjian2*
 1.Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; 2.Department of Anesthesiology,
the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002
关键词:
 ; 右美托咪定; 芬太尼; 插管反应; 剂量效应关系; 药物
Keywords:
 ; exmedetomidine;  fentanyl;  intubation response;  dose-response relationship;  drug
分类号:
R614
文献标志码:
A
摘要:
 目的通过测定右美托咪定对芬太尼诱导抑制插管反应半数有效量的影响，评价右美托咪定对芬太尼抑制插管反应作用的影响。方法选择40例全麻下择期行妇科腹腔镜手术的患者，ASAⅠ～Ⅱ级，随机分为右美托咪定组(D组，n=20)和对照组(C组,n=20)。D组患者麻醉诱导前泵注0.6 μg/kg右美托咪定(10 min注射完毕)，C组患者相同方法给予等量生理盐水，观察5 min后开始麻醉诱导。靶控输注（TCI）血浆靶浓度为3 mg/L的丙泊酚，同时30 s静脉注射预设剂量的芬太尼，按序贯法确定芬太尼的剂量（相邻剂量之间的比率为1.2），患者意识消失后给予罗库溴铵行气管插管。记录麻醉诱导前（T0）血压（BP）、心率（HR）、脑电双频指数（BIS）的基础值以及插管前即刻（T1）、插管后1 min（T2）、5 min（T3）时的变化情况。结果运用可视喉镜气管插管时，D组和C组芬太尼抑制插管反应的ED50（95% CI）分别为3.06 μg/kg（2.82～3.31 μg/kg）和4.32 μg/kg（3.96～4.71 μg/kg），D组ED50低于C组（P<0.05）。结论麻醉诱导前单次输注右美托咪定0.6 μg/kg可减少芬太尼抑制气管插管反应的ED50，提示右美托咪定可加强芬太尼抑制插管反应的作用。
Abstract:
 ObjectiveTo evaluate the effects of dexmedetomidine on the median effective dose of fentanyl to prevent endotracheal intubation. MethodsA total of 40 ASA Ⅰ-Ⅱ patients who were scheduled for gynecologic laparoscopy under general anesthesia were enrolled in the study. The patients were randomly divided into two groups: a dexmedetomidine group (Group D) and a control group (Group C) (n=20). Before anesthestic induction, Group D received 0.6 μg/kg dexmedetomidine by intravenous infusion within 10 min, and Group C received an equal volume of normal saline with Group D. Propofol was given by target controlled infusion (TCI) at a target plasma concentration of 3 mg/L, while a predetermined dose of fentanil was injected over 30 s. The dose of fentanil was determined by up-and-down method (at a ratio of 1.2 between adjacent doses). When the patients became unconscious, intravenous rocuronium was given to facilitate tracheal intubation. Then, blood pressure (BP), heart rate (HR) and bispectral index (BIS) were recorded before anesthetic induction (T0), before intubation (T1), and 1 min and 5 min after intubation (T2 and T3). ResultsThe ED50 (the 95% confidence intervals) of fentanyl in Groups D and C were 3.06 μg/kg (2.82-3.31 μg/kg) and 4.32 μg/kg (3.96-4.71 μg/kg) respectively, during endotracheal intubation using visual laryngoscopy. The ED50 of fentanyl in Group D was lower than that in Group C (P<0.05). ConclusionsSingle infusion of 0.6 μg/kg dexmedetomidine prior to anesthetic induction can decrease the ED50 of fentanyl to prevent endotracheal intubation response, which indicates that dexmedetomidine enhances the potency of fentanyl to prevent endotracheal intubation response.

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备注/Memo

备注/Memo:
通信作者,E-mail:liugongjian61@hotmail.com
收稿日期：2017-01-12修回日期：2017-04-30
更新日期/Last Update: 2017-07-14