Department of Anesthesiology, Guangzhou Women and Children Medical Center, Guangzhou Medical University affiliated Women and Children Medical Center, Guangzhou, China (mainland).
Med Sci Monit. 2014 Dec 14;20:2658-65. doi: 10.12659/MSM.891276.
The minimum alveolar concentration (MAC) of sevoflurane in neonates is 3.3%, but this value has not been verified in Chinese neonates and the effect of different doses of fentanyl on MAC in neonates has not been investigated. This study was designed to determine the ED₅₀ and ED₉₅ values of sevoflurane in Chinese neonates with and without fentanyl.
Ninety-three neonates were randomly assigned to receive sevoflurane alone (control group, n=30), 1 µg/kg sevoflurane (group fent1, n=29), or 2 µg/kg fentanyl (group fent2, n=32). Following inhalational induction and tracheal intubation, the end-tidal concentration of sevoflurane was adjusted to achieve the designated concentration, which was determined using the modified Dixon's up-and-down method starting with 3.0% in each group, with a 0.25% step size. Success was defined as no motor response within 60 s of skin incision.
The MAC (standard deviation) values of sevoflurane were 2.91% (0.27) in the control group, 2.53% (0.31) in the fent1 group, and 2.34% (0.33) in the fent2 group according to Dixon's up-and-down method. Logistic probit regression analysis revealed that the ED₅₀ and ED₉₅ (95% CI) of sevoflurane in neonates were 2.82% (2.66-2.98) and 3.39% (2.89-3.89), respectively, in the control group; 2.44% (2.19-2.68) and 3.30% (2.51-4.09), respectively, in the fent1 group; and 2.21% (1.97-2.45) and 3.11% (2.35-3.88), respectively, in the fent2 group.
The MAC value of sevoflurane in Chinese neonates was lower than previously reported and was reduced by the addition of fentanyl.
七氟醚在新生儿中的最低肺泡浓度（MAC）为 3.3%，但这一数值尚未在中国新生儿中得到验证，且不同剂量芬太尼对新生儿 MAC 的影响也尚未被研究。本研究旨在确定中国新生儿在接受七氟醚和芬太尼时的 ED₅₀和 ED₉₅值。
93 名新生儿被随机分为三组：单独接受七氟醚（对照组，n=30）、1µg/kg 七氟醚（组 fent1，n=29）或 2µg/kg 芬太尼（组 fent2，n=32）。在吸入诱导和气管插管后，根据改良 Dixon 上下法，将七氟醚的呼气末浓度调整至设定浓度，每组起始浓度为 3.0%，步长为 0.25%。成功定义为皮肤切开后 60 秒内无运动反应。
根据 Dixon 上下法，对照组、组 fent1 和组 fent2 的七氟醚 MAC（标准差）值分别为 2.91%（0.27）、2.53%（0.31）和 2.34%（0.33）。Logistic 概率回归分析显示，对照组中七氟醚的 ED₅₀和 ED₉₅（95%CI）分别为 2.82%（2.66-2.98）和 3.39%（2.89-3.89）；组 fent1 中分别为 2.44%（2.19-2.68）和 3.30%（2.51-4.09）；组 fent2 中分别为 2.21%（1.97-2.45）和 3.11%（2.35-3.88）。
中国新生儿七氟醚的 MAC 值低于既往报道，且加入芬太尼后会降低。
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