Hung Nan-Kai, Lee Meei-Shyuan, Lai Hou-Chuan, Huang Yi-Hsuan, Lin Bo-Feng, Chan Shun-Ming, Wu Zhi-Fu
Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center.
School of Public Health, National Defense Medical Center.
Medicine (Baltimore). 2020 Jan;99(1):e18669. doi: 10.1097/MD.0000000000018669.
In ophthalmic surgery, coughing during emergence from general anesthesia may have a detrimental effect on intraocular pressure. Tracheal suction during emergence may elicit this reflex. The optimal effect-site concentration (EC) of propofol to prevent triggering of the cough reflex during tracheal suctioning is unknown. The aim of this study is to assess the optimal EC of propofol for tracheal suctioning during emergence in patients undergoing ophthalmic surgery.Twenty-one patients were enrolled, all of them American Society of Anesthesiologists (ASA) physical status I or II non-smokers undergoing ophthalmic surgery. Anesthesia was induced and maintained under total intravenous anesthesia using target-controlled infusion. During emergence from general anesthesia, tracheal suction was performed at different propofol concentrations as required for Dixon's up-and-down method with a step size of 0.2 μg/ml. A propofol concentration at which the cough reflex was not triggered during tracheal suctioning was considered successful.The EC50 of propofol for tracheal suction without cough was 1.4 μg/ml and the EC95 was 1.6 μg/ml.Tracheal suction may be accomplished without triggering the cough reflex when the propofol effect-site concentration is higher than 1.6 μg/ml.
在眼科手术中，全身麻醉苏醒期咳嗽可能会对眼压产生不利影响。苏醒期气管吸引可能引发这种反射。异丙酚预防气管吸引时咳嗽反射触发的最佳效应室浓度（EC）尚不清楚。本研究的目的是评估眼科手术患者苏醒期气管吸引时异丙酚的最佳EC。纳入21例患者，均为美国麻醉医师协会（ASA）身体状况I或II级的非吸烟眼科手术患者。采用靶控输注在全静脉麻醉下诱导和维持麻醉。在全身麻醉苏醒期，根据Dixon上下法，以0.2μg/ml的步长，在不同异丙酚浓度下进行气管吸引。气管吸引时未触发咳嗽反射的异丙酚浓度视为成功。异丙酚用于无咳嗽气管吸引的EC50为1.4μg/ml，EC95为1.6μg/ml。当异丙酚效应室浓度高于1.6μg/ml时，气管吸引可在不触发咳嗽反射的情况下完成。
