【摘要】 目的:测定小剂量(50μg)芬太尼在老龄女性喉罩置入时丙泊酚半数有效浓度(EC50)的影响,探讨合理的诱导药物配伍。方法:择期行全麻下乳腺手术女性患者84例,根据年龄分为老年组(≥65岁)和中青年组(<65岁),每组再随机分为芬太尼复合丙泊酚组及单纯丙泊酚组,应用Dixon序贯法预设丙泊酚效应部位靶控输注浓度,并计算各组EC50值。结果:中青年(N)组、中青年复合芬太尼(N+f)组、老年(G)组、老年复合芬太尼(G+f)组EC50分别为(4.03±0.21)、(3.07±0.24)、(3.76±0.42)、(2.38±0.22)mg/L,除N组、G组外,其余各组比较差异有统计学意义(P<0.01)。复合芬太尼2组诱导过程低血压、心动过缓发生率与对应未加芬太尼组比较差异均无统计学意义,插入喉罩无知晓事件,但G+f组呼吸暂停发生率较G组增加。结论:小剂量芬太尼可有效降低喉罩插入所需丙泊酚靶控输注的EC50,这种协同作用对于老年人更明显且不增加低血压和心动过缓的发生率。更多还原

【Abstract】 Objective:To investigate whether supplemental low dose fentanyl(50 μg) decreased the median effective concentration of propofol using a target controlled infusion technology(TCI) to secure laryngeal mask insertion in aged female patients.Methods:Eighty-four elective patients were divided into 2 groups by ages and then randomly assigned to four groups(n=21 for each group),non-aged patients(<65 ages) were given saline(group N),non-aged patients were given fentanyl 50 μg(group N+f),aged patients(≥65 ages) were given saline(group G) and aged patients were given fentanyl 50 μg(group G+f).Target effect-site concentration of propofol was determined and EC50 was calculated by a modification of Dixon’s up-and-down method.Results:The values of EC50 were(4.03±0.21)mg/L(group N),(3.07±0.24)mg/L(group N+f),(3.76±0.42)mg/L(group G) and(2.38±0.22)mg/L(group G+f).There were significant differences between groups except N and G group(P < 0.01).The incidence of hypotension and bradyrhythmia was similar in groups combined with fentanyl,and no awareness happened in all patients,but the incidence of apnea was more in group G+f than that of group G.Conclusion:A fentanyl dose of 50 μg is sufficient to decrease EC50 of propofol TCI to secure laryngeal mask insertion in normal and geriatric patients with minimum cardiovascular depression.更多还原