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在中国儿科患者中,为获得满意的喉罩气道(LMA)插入条件而使用舒芬太尼的最佳推注剂量:一项前瞻性双盲随机对照试验(CONSORT)

The optimal bolus dose of sufentanil for satisfactory laryngeal mask airway (LMA) insertion conditions in chinese pediatric patients: A prospective double-blind randomized controlled trial (CONSORT).

作者信息

Li Na, Chen Yong, Ouyang Bishan, Li Guige, Lin Guanwen, Li Yan, Li Tiejun

机构信息

Department of Anesthesiology, Hainan General Hospital, Haikou, Hainan Province, China.

出版信息

Medicine (Baltimore). 2019 Mar;98(10):e14711. doi: 10.1097/MD.0000000000014711.

Abstract

BACKGROUND

This study aimed to estimate the optimal dose of sufentanil, coadministered with 2.5 mg/kg propofol, for satisfactory laryngeal mask airway (LMA) insertion conditions in Chinese children and to determine the optimal bolus dose.

METHODS

Seventy-five Chinese children aged 2 to 6 years with the American Society of Anesthesiologists physical status I or II, undergoing elective minor surgery were recruited. They were randomly divided into 5 different dosage groups (0, 0.05, 0.1, 0.15, 0.2 μg/kg). A predetermined sufentanil diluted with 5 mL saline was injected 30 s, 200 s later, followed by 2.5 mg/kg propofol over 10 s. After that the insertion conditions were assessed, using a 6-category score. The duration of apnea was recorded. A Probit analysis was performed to determine the ED50 and ED95 with 95% confidence interval for optimal conditions.

RESULTS

There were less hemodynamic changes in all sufentanil groups than propofol-only group, with 0.2 μg/kg patients showing the most stable cardiovascular responses and best insertion conditions. However, the duration of apnea increased with the increasing dosage of sufentanil. From Probit analysis, the ED50 and ED95 of sufentanil for optimum score were 0.064 μg/kg and 0.177 μg/kg, respectively.

CONCLUSION

In combination with propofol for anesthesia induction in Chinese children, sufentanil 0.2 μg/kg could prevent patients from dramatic hemodynamic change, providing satisfactory LMA insertion conditions.

摘要

背景

本研究旨在评估在中国儿童中,与2.5mg/kg丙泊酚联合使用时,舒芬太尼达到满意喉罩置入条件的最佳剂量,并确定最佳推注剂量。

方法

招募75名年龄在2至6岁、美国麻醉医师协会身体状况分级为I或II级、接受择期小手术的中国儿童。他们被随机分为5个不同剂量组(0、0.05、0.1、0.15、0.2μg/kg)。在30秒、200秒后,分别静脉注射用5mL生理盐水稀释的预定剂量舒芬太尼,随后在10秒内静脉注射2.5mg/kg丙泊酚。之后,使用6级评分法评估置入条件。记录呼吸暂停的持续时间。进行概率分析以确定达到最佳条件的半数有效剂量(ED50)和95%有效剂量(ED95)及其95%置信区间。

结果

所有舒芬太尼组的血流动力学变化均少于单纯丙泊酚组,其中0.2μg/kg组患者的心血管反应最稳定,置入条件最佳。然而,呼吸暂停的持续时间随着舒芬太尼剂量的增加而延长。通过概率分析,舒芬太尼达到最佳评分的ED50和ED95分别为0.064μg/kg和0.177μg/kg。

结论

在中国儿童麻醉诱导中,舒芬太尼0.2μg/kg与丙泊酚联合使用可防止患者出现剧烈血流动力学变化,提供满意的喉罩置入条件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2015/6417634/82163504e468/medi-98-e14711-g002.jpg

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