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依托咪酯复合小剂量舒芬太尼用于宫腔镜静脉麻醉的 ED50。

ED50 of propofol in combination with low-dose sufentanil for intravenous anaesthesia in hysteroscopy.

机构信息

Department of Anesthesiology, Chongqing Health Center for Women and Children, Chongqing, China.

出版信息

Basic Clin Pharmacol Toxicol. 2019 Nov;125(5):460-465. doi: 10.1111/bcpt.13280. Epub 2019 Jul 9.

Abstract

OBJECTIVES

Sufentanil has favourable pharmacodynamic and pharmacokinetic properties as an opioid, and it is usually co-administered with propofol as intravenous anaesthesia for hysteroscopic examination or therapeutic surgery. However, the optimal dosage of propofol when it is co-administered with low-dose sufentanil has not yet been established. This study was designed to find the median effective dose of propofol for intravenous anaesthesia when combined with low-dose sufentanil.

METHODS

Fifty-four patients were enrolled and randomized into two groups in this prospective study. Sufentanil 0.2 μg/kg (Group A) or 0.1 μg/kg (Group B) was given intravenously before speculum placement. The initial propofol dose was set at 2 mg/kg and varied by 0.1 mg/kg according to the sequential allocation up-and-down rule designed by Dixon and Massey. Respiratory depression, duration of initial dose of propofol, total drug quantity administered and recovery time were recorded.

RESULTS

The ED50 of propofol was 1.651 mg/kg (95% CI, 1.561-1.722 mg/kg) in Group A and 1.991 mg/kg (95% CI, 1.902-2.081 mg/kg) in Group B. The ED95 of propofol was 1.827 mg/kg (95% CI, 1.746-2.236 mg/kg) in Group A and 2.153 mg/kg (95% CI, 2.070-2.73 7 mg/kg) in Group B. The initial and total dosage of propofol in Group A were significantly lower than those in Group B, but the incidence of respiratory depression in Group A (26.67%) was significantly higher than that in Group B (4.17%).

CONCLUSION

The ED50 values for propofol when co-administered with low-dose sufentanil for intravenous anaesthesia in hysteroscopy were 1.651 mg/kg (sufentanil 0.2 μg/kg) and 1.991 mg/kg (sufentanil 0.1 μg/kg). (www.chictr.org.cn, registration number: ChiCTR1900021224).

摘要

目的

舒芬太尼具有良好的药效学和药代动力学特性,是一种阿片类药物,通常与丙泊酚联合用于宫腔镜检查或治疗性手术的静脉麻醉。然而,当与低剂量舒芬太尼联合使用时,丙泊酚的最佳剂量尚未确定。本研究旨在确定与低剂量舒芬太尼联合使用时丙泊酚的半数有效剂量。

方法

本前瞻性研究纳入了 54 名患者,并将其随机分为两组。在放置窥器前,两组患者分别静脉注射舒芬太尼 0.2μg/kg(A 组)或 0.1μg/kg(B 组)。初始丙泊酚剂量设定为 2mg/kg,并根据 Dixon 和 Massey 设计的序贯分配上下法,以 0.1mg/kg 的增量进行调整。记录呼吸抑制、丙泊酚初始剂量持续时间、总药物用量和恢复时间。

结果

A 组丙泊酚的 ED50 为 1.651mg/kg(95%CI:1.561-1.722mg/kg),B 组为 1.991mg/kg(95%CI:1.902-2.081mg/kg)。A 组丙泊酚的 ED95 为 1.827mg/kg(95%CI:1.746-2.236mg/kg),B 组为 2.153mg/kg(95%CI:2.070-2.737mg/kg)。A 组丙泊酚的初始剂量和总剂量明显低于 B 组,但 A 组呼吸抑制的发生率(26.67%)明显高于 B 组(4.17%)。

结论

宫腔镜检查中,舒芬太尼低剂量与丙泊酚联合静脉麻醉时,丙泊酚的 ED50 值分别为 1.651mg/kg(舒芬太尼 0.2μg/kg)和 1.991mg/kg(舒芬太尼 0.1μg/kg)。(www.chictr.org.cn,注册号:ChiCTR1900021224)。

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