Chen Nanjin, Wang Xiaodan, Chen Lingyang, Wang Mingcang, Jiang Yongpo
Department of Anesthesiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.
Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.
J Thorac Dis. 2022 May;14(5):1537-1543. doi: 10.21037/jtd-22-412.
In practice, the optimal dose of alfentanil that should be used when painless bronchoscopy is performed is unknown. The purpose of this study was to investigate the effective dose of alfentanil in suppressing bronchoscopy responses to painless bronchoscopy with an i-gel supraglottic airway device.
Patients aged 18-70 years, with American Society of Anesthesiologists (ASA) physical status I-II, who planned to undergo painless bronchoscopy were recruited for this study. Alfentanil was administered intravenously 2 minutes before propofol administration. The response to bronchoscopy was measured, including oxygen saturation (SPO) and changes in respiratory rhythm. The median effective dose of alfentanil (ED) required to alleviate responses to the bronchoscopy was calculated using Dixon's up-and-down method in the female and male groups. Probit analysis was used to generate a dose-response curve in each group.
A total of 48 patients were recruited for the study including 25 females and 23 males. The ED of alfentanil for suppressing responses to painless bronchoscopy in females and males was 13.68±4.75 and 17.96±3.45 µg/kg, respectively. The difference was not statistically significant between the two groups (P=0.078). Probit analysis showed the ED of alfentanil in female bronchoscopy was 12.4 µg/kg [95% confidence interval (CI): 4.5 to 17 µg/kg]. In men, the ED of alfentanil was 16.4 µg/kg (95% CI: 12.1 to 20.1 µg/kg). According to the probit analysis, the 95% effective dose (ED) of alfentanil was 22.4 µg/kg (95% CI: 17.5 to 67.3 µg/kg) in female bronchoscopy. In men, the ED of alfentanil was 23.3 µg/kg (95% CI: 19.8 to 46.2 µg/kg).
Our data suggest that there were no obvious differences between men and women in the effective dose of alfentanil in painless bronchoscopy.
在实际操作中，无痛支气管镜检查时应使用的阿芬太尼最佳剂量尚不清楚。本研究的目的是探讨阿芬太尼抑制使用i-gel喉罩进行无痛支气管镜检查时支气管镜检查反应的有效剂量。
招募年龄在18 - 70岁、美国麻醉医师协会（ASA）身体状况为I-II级、计划进行无痛支气管镜检查的患者参与本研究。在丙泊酚给药前2分钟静脉注射阿芬太尼。测量支气管镜检查的反应，包括血氧饱和度（SPO）和呼吸节律变化。使用狄克逊上下法计算女性和男性组缓解支气管镜检查反应所需的阿芬太尼中位有效剂量（ED）。每组使用概率分析生成剂量反应曲线。
本研究共招募48例患者，其中女性25例，男性23例。阿芬太尼抑制女性和男性无痛支气管镜检查反应的ED分别为13.68±4.75和17.96±3.45μg/kg。两组之间差异无统计学意义（P = 0.078）。概率分析显示，女性支气管镜检查中阿芬太尼的ED为12.4μg/kg [95%置信区间（CI）：4.5至17μg/kg]。在男性中，阿芬太尼的ED为16.4μg/kg（95%CI：12.1至20.1μg/kg）。根据概率分析，女性支气管镜检查中阿芬太尼的95%有效剂量（ED）为22.4μg/kg（95%CI：17.5至67.3μg/kg）。在男性中，阿芬太尼的ED为23.3μg/kg（95%CI：19.8至46.2μg/kg）。
我们的数据表明，无痛支气管镜检查中阿芬太尼的有效剂量在男性和女性之间没有明显差异。
