注册本刊作者作者投稿查稿
专家远程审稿编辑在线审稿
编务办公专区主编办公专区
下载文档
工作动态
联系方式
发行周期:
月刊
主管单位:
上海市卫生健康委员会
主办单位:
上海市医学会
编辑出版:
《上海医学》编辑部
联系地址:
上海市北京西路1623号
邮编:
200040
电话:
021-62178606
传真:
021-62178606
邮箱:
smasmj@shsma.org.cn
ISSN:
ISSN0253-9934
CN:
CN31-1366/R
收款账号:
1001255309008900719
账户名:
上海市医学会
开户行:
工商银行上海市静安寺支行
友情链接

当前位置：首页 > 过刊浏览->2010年第10期

小儿麻醉诱导期阿片类药物对异丙酚镇静作用的影响
The effects of opioid and propofol on sedation during induction in children

浏览(2462) 下载(0)

DOI:
作者:
黄 悦，白 洁，杭燕南，张马忠，陈 煜
HUANG Yue*, Bai Jie, HANG Yan-nan,et al.
作者单位:
上海儿童医学中心
Department of Anesthesiology,Shanghai Children’s Medical Centre affiliated to Shanghai Jiaotong University,school of medicine,Shanghai 200127,China
关键词:
脑电双频指数；阿片类药；异丙酚；小儿麻醉；靶控输注
Bispectral index；Opioid；Propofol；Pediatric anesthesia；Target- controlled infusion；Drug interaction
摘要:
目的 基于小儿麻醉诱导期脑电双频指数（BIS）及异丙酚效应室浓度的变化，定量分析阿片类药物对异丙酚镇静药效学的影响。方法 45例不用术前药的患儿随机分为3组：C组静脉输注0.9% 氯化钠；R组静脉输注瑞芬太尼0.3μg•kg-1•min-1；S组静脉输注舒芬太尼0.02μg•kg-1•min-1。30min后开始异丙酚靶控输注，异丙酚起始效应室浓度1μg/ml逐渐递增至4μg/ml。于基础时点、阿片类药输注30 min后、异丙酚达预设浓度1min后及意识消失即刻记录BIS、效应室浓度、改良OAA/S评分、HR、SBP及MAP。结果 BIS与异丙酚效应室浓度及OAA/S评分显著相关；异丙酚EC50（意识消失） R组1.02μg/ml、S组0.98μg/ml显著低于C组1.98μg/ml（P<0.05）；R组和S组BIS50分别为85、83，较C组75显著升高（P<0.05）。结论 复合使用阿片类药物，患儿异丙酚意识消失的EC50降低；但与异丙酚相互作用却可使意识消失时的BIS值升高，因此BIS不能很好地反映患儿的镇静状态。
Objective To analyze quantitatively the influence of opioids on propofol pharmacodynamics based on the changes of BIS, propofol effect-site concentration during induction in pediatric patients. Methods Forty-five unpremedicated pediatric patients were randomly assigned to three groups: the patients received 0.9% NaCl, sufentanil 0.02μg•kg-1•min-1, remifentanil 0.3μg•kg-1•min-1 in group C, R and S for 30min. Then, the patients received target-controlled effect site concentration infusion of propofol, the concentration was increased gradually from 1~4μg/ml. The target effect-site concentration of propofol, BIS value, OAA/S score and hemodynamic variables were monitored and recorded. Results BIS correlated significantly with sedation scores, propofol effect-site concentration in all groups. The EC50 of propofol for loss of consciousness (LOC) was lower significantly in group R 1.02μg/ml, S 0.98μg/ml compared with that in group C 1.98μg/ml (P<0.05). The BIS50 85, 83 in group R and S at loss of consciousness was significantly higher than of 75 in group C (P<0.05). Conclusions When sufentanil or remifentanil combined with propofol, the EC50 of propofol decreased with an increased BIS50 at LOC, which suggests that BIS is not a good indicator of sedation.

 

主管单位：上海市卫生健康委员会  主办单位：上海市医学会
©2025《上海医学》编辑部 沪ICP备09078599号
您是本站第26803293名访问者
网站管理