摘要
目的:测定妇科手术后舒芬太尼持续硬膜外镇痛的半数有效浓度。方法:择期行妇科手术患者30例,年龄20～50岁,美国麻醉医师协会术前身体状况分级(ASA)Ⅰ～Ⅱ级,体质量指数(BMI)<30kg.m-2,手术时间1.5～2h。术毕留置硬膜外导管接镇痛泵。舒芬太尼的浓度按序贯法确定:即当前患者的药物浓度由上一例患者的反应决定,如果上一例镇痛有效,则当前患者药物降低一个浓度梯度。如果镇痛无效,则上升一个浓度梯度。从舒芬太尼1mg.L-1开始,各相邻浓度之间的比值1.2。若镇痛效果可疑,则下一例接受的药物维持原浓度,计算舒芬太尼的半数有效浓度(EC50)及其95%的可信区间,观察镇痛期间的不良反应。结果:舒芬太尼持续硬膜外输注的EC50为0.87mg.L-1,95%的可信区间为0.79～0.96mg.L-1。皮肤瘙痒的发生率3.8%,恶心、呕吐的发生率11.5%。结论:妇科手术后舒芬太尼持续硬膜外输注的EC50为0.87mg.L-1。
OBJECTIVE To determine the median effective concentration （EC50） of continuous epidural sufentainil infusion analgesia after gynecological surgery, METHODS Forty ASA Ⅰ or Ⅱ patients aged 20-50 yr with body weight index〈30 kg·m^-2 undergoing e lective lower abdominal gynecological operation under epidural anesthesia received continuous epidural sufentanil infusion（CEI） for 48h. epidural catheter was placed at L1-2. CEI device was set up to deliver sufentanil solution at 2 mL·h^-1 after a loading dose of 5 mL. The EC50 of sufentanil was determined by up and down sequential test. The concentration of sufentanil was increased or decreased with ratio of 1.2. If effective, the next patient received sufentanil at a lower concentration, if ineffective a higher concentration. VAS （0-10,0 = no pain, 10 = worst pain）was used to assess the analgesia. If the VAS score was ≤ 3 within 8h after sufentanil administration, analgesia was defined as effective. The up and down sequences were analyzed by using Dixon method to determine the EC50 and 95 % confidence interval（CI）. The side effects were also recorded. RESULTS The EC50 of sufentanil CEI was 0. 87 mg L^-1. 95% confidence interval was between 0. 79 mg·L^-1 and 0. 96 mg·L^-1. The incidence of pruritus was 3. 8%. There were 3 patients who had nausea and vomiting. No patients had respiratory depression. CONCLUSlON The EC50 of continuous epidural sufentanil infusion analgesia after gynecologi cal surgery was 0. 87 mg·L^-1.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2008年第22期1931-1933,共3页
Chinese Journal of Hospital Pharmacy
关键词
舒芬太尼
镇痛
硬膜外
妇科
剂量效应关系
sufentanil
analgesia, epidural
Dose-response relationship, drug
