摘要
目的确定复合七氟烷吸入用于患儿无肌松药气管插管时瑞芬太尼的半数有效剂量（ED50）。方法择期手术患儿25例，年龄4～9岁，ASAⅠ或Ⅱ级。吸入5％七氟烷行麻醉诱导，维持呼气末二氧化碳分压30～35mmHg。吸入七氟烷3min后静脉注射瑞芬太尼，注射时间308，瑞芬太尼注射完毕后90s时行气管插管。采用序贯法进行试验，瑞芬太尼初始剂量为1．2gg／kg，相邻剂量比值为1．2。采用Viby—Mogensen评分法评价气管插管条件，气管插管失败时，静脉注射罗库溴铵0．3mg／kg，待肌肉松驰后再行气管插管。计算瑞芬太尼的ED50及其95％可信区间。结果复合5％七氟烷吸入用于患儿无肌松药气管插管时瑞芬太尼的ED550及其95％可信区间为0．68（0．65～0．71）μg／kg。结论复合5％七氟烷吸入用于患儿无肌松药气管插管时瑞芬太尼的ED50。及其95％可信区间为0．68（0．65～0．71）μg／kg。
Objective To determine the ED50 of remifentanil needed for tracheal intubation without neuromuscular relaxant in children when combined with sevoflurane inhalation. Methods Twenty-five ASA Ⅰ or Ⅱ children of both sexes, aged 4-9 yr, scheduled for elective surgery under general anesthesia were enrolled in this study. Anesthesia was induced with inhalation of 5 % sevoflurane in 100% oxygen and PRTCO2 was maintained at 30-35 mm Hg. Remifentanil was injected intravenously over 30 s after 3 min inhalation of sevoflurane. Traeheal intubation was performed 90 s after the completion of remifentanil injection. The experiment was performed using the modified Dixon＇s up-and-down method. The initial dose of remifentanil was set at 1.2 μg/kg and the ratio between two successive doses was 1.2. Intubation conditions were assessed by a blinded observer using Viby- Mogensen scale. If the conditions were not good, rocuronium 0.3 mg/kg was then injected intravenously to facilitate intubation. The ED50 of remifentanil and 95% confidence interval （95% CI） were calculated. Results The ED50 of remifentanil combined with inhalation of sevoflurane required for successful iutubation was 0.68 μg/kg in the absence of neuromuscular relaxant, and 95% CI was 0.65-0.71 μg/kg. Conclusion The ED50 of remifeutanil required for tracheal intubation without neuromuscular relaxant drug is 0168 μg/kg （95 % CI 0.65- 0.71 μg/kg） when combined with 5% sevoflurane inhalation in children.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2009年第5期398-400,共3页
Chinese Journal of Anesthesiology
关键词
哌啶类
麻醉药
吸入
插管法
气管内
剂量效应关系
药物
儿童
Piperidines
Anesthetics, inhalation
Intubation, intratracheal
Dose-response relationship, drug
Child
