瑞芬太尼麻醉引起回、汉两族患者呼吸抑制的靶控C_(P50)研究
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摘要
目的探讨西宁地区回族与汉族手术患者瑞芬太尼麻醉引起呼吸抑制时靶控半数有效血浆靶浓度(C_(P50))的临床研究。方法选取瑞芬太尼麻醉手术患者120例为研究对象,根据不同民族将其分为回族组与汉族组,各60例。采用Dixno序贯法进行试验,瑞芬太尼起始靶浓度为5.0μg/mL,最低靶浓度为2.5μg/mL。比较两组呼吸抑制发生情况、临床表现以及呼吸抑制时靶控C_(P50)等。结果回族组呼吸抑制发生率为43.33%,汉族组发生率为46.67%,两组比较差异无统计学意义(P>0.05);两组发生呼吸抑制时靶控C_(P50)比较差异无统计学意义(P>0.05);两组呼吸抑制均主要发生在瑞芬太尼输注后15min内,临床以RR、SpO2降低为主,两组1～5min、6～10min、11～15min等各时间段呼吸抑制发生率、临床表现、是否发生呼吸抑制患者的临床资料及不良反应等比较差异均无统计学意义(P>0.05)。结论西宁地区回族与汉族手术患者输注瑞芬太尼引起呼吸抑制的主要时间为5～15min内,靶控C_(P50)浓度分别为(3.29±0.15)μg/mL、(3.31±0.17)μg/mL,呼吸抑制时均以RR及SpO2降低为主要临床表现,回族与汉族之间靶控C_(P50)、呼吸抑制发生时间及临床主要表现等均无统计学差异。
Objective To investigate the clinical study of target-controlled effective plasma target concentration(CP50)in respiratory depression induced by remifentanil anesthesia in Hui and Han surgical patients in Xining area.Methods 120 patients who underwent remifentanil anesthesia in our hospital were selected as the study subjects.According to different nationalities,they were divided into Hui group and Han group,60 cases in each group.Dixno sequential method was used in the experiment.The initial target concentration of remifentanil was 5.0μg/mL and the minimum target concentration was 2.5μg/mL.The incidence of respiratory depression,clinical manifestations and target controlled CP50 during respiratory depression were compared between the two groups.Results The incidence of respiratory depression was 43.33%in Hui group and 46.67%in Han group(P>0.05).The target-controlled CP50 was compared between the two groups(P>0.05).The respiratory depression in both groups occurred mainly within 15 minutes after remifentanil infusion,and RR was the most common clinical manifestation.SpO2 decreased mainly.There were no statistical significantly differences in the incidence of respiratory depression,clinical manifestations,clinical data of patients with or without respiratory depression and adverse reactions between the two groups at 1～5min,6～10min and 11～15min(P>0.05).Conclusion The main time of respiratory depression caused by remifentanil infusion in Hui and Han surgical patients in Xining area is within 5～15minutes.The concentration of target-controlled CP50is(3.29+0.15)μg/mL and(3.31+0.17)μg/mL,respectively.The main clinical manifestations of respiratory depression are the decrease of RR and SpO2.Target-controlled CP50 and respiratory depression occur between Hui and Han nationalities.There was no significant difference in time and clinical manifestation.
Objective To investigate the clinical study of target-controlled effective plasma target concentration(CP50)in respiratory depression induced by remifentanil anesthesia in Hui and Han surgical patients in Xining area.Methods 120 patients who underwent remifentanil anesthesia in our hospital were selected as the study subjects.According to different nationalities,they were divided into Hui group and Han group,60 cases in each group.Dixno sequential method was used in the experiment.The initial target concentration of remifentanil was 5.0μg/mL and the minimum target concentration was 2.5μg/mL.The incidence of respiratory depression,clinical manifestations and target controlled CP50 during respiratory depression were compared between the two groups.Results The incidence of respiratory depression was 43.33%in Hui group and 46.67%in Han group(P>0.05).The target-controlled CP50 was compared between the two groups(P>0.05).The respiratory depression in both groups occurred mainly within 15 minutes after remifentanil infusion,and RR was the most common clinical manifestation.SpO2 decreased mainly.There were no statistical significantly differences in the incidence of respiratory depression,clinical manifestations,clinical data of patients with or without respiratory depression and adverse reactions between the two groups at 1～5min,6～10min and 11～15min(P>0.05).Conclusion The main time of respiratory depression caused by remifentanil infusion in Hui and Han surgical patients in Xining area is within 5～15minutes.The concentration of target-controlled CP50is(3.29+0.15)μg/mL and(3.31+0.17)μg/mL,respectively.The main clinical manifestations of respiratory depression are the decrease of RR and SpO2.Target-controlled CP50 and respiratory depression occur between Hui and Han nationalities.There was no significant difference in time and clinical manifestation.
引文
[1]梁跃新.瑞芬太尼联合丙泊酚全凭静脉麻醉抑制气管拔管期副作用最低有效浓度[J].国际麻醉学与复苏杂志,2017,38(10):899-902.
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[4]金成林.瑞芬太尼用于预防全身麻醉术后患者围拔管期不良反应的效果观察[J].中国现代药物应用,2017,11(9):122-123.
[5]刘广林,路志红,陈敏,等.中国西北部地区汉族患者麻醉药物相关基因多态性的分布[J].临床麻醉学杂志,2017(12):1149-1151.
[6]莫利群,曹露,吴刚明.靶控输注瑞芬太尼引起呼吸抑制的半数有效血浆靶浓度的研究[J].实用医院临床杂志,2015,12(01):74-76.
[7]刘利佳,王钟宇,金波,等.靶控输注瑞芬太尼半最大效应浓度的临床研究[J].实用药物与临床,2016,19(7):848-850.
[8] Hannam JA,Borrat X,Troconiz IF,et al.Modeling respiratory depression induced by remifentanil and propofol during sedation and analgesia using a continuous noninvasive measurement of pCO2[J].Journal of Pharmacology&Experimental Therapeutics,2015,356(3):563-573.
[9] Dahan A,Douma M,Olofsen E,et al.High inspired oxygen concentration increases the speed of onset of remifentanil-induced respiratory depression[J].British Journal of Anaesthesia,2016,116(6):879.
[10]彭粤,任从才,高新跃,等.瑞芬太尼呼吸抑制EC50与高强度聚焦超声热剂量的关系研究[J].海南医学,2012,23(5):9-11.
[11]姜卫荣,王金波,陈秀梅,等.胃癌根治术中瑞芬太尼复合丙泊酚的麻醉效果观察[J].中国临床医生,2016,44(7):49-51.
[12]冯建刚,石改萍,范勇民.不同剂量瑞芬太尼持续输注对小儿七氟烷麻醉下自主呼吸的影响[J].智慧健康,2017,3(25):84-85.
[13]张熙哲,吴新民.腰麻病人瑞芬太尼和舒芬太尼呼吸抑制的半数血浆靶浓度[J].中华麻醉学杂志,2007,27(1):58-61.
[14]徐兆景,王涛,徐昕明,等.不同海拔高度地区部队官兵高原驻训健康状况调查分析[J].西南国防医药,2016,26(3):344-346.
[2] Cárdenas VHG,González FDM,Barajas WJG,et al.Remifentanil vs.epidural analgesia for the management of acute pain associated with labour.Systematic review and meta-analysis[J].Colombian Journal of Anesthesiology,2014,42(4):281-294.
[3] Guo Z,Pang L,Jia X,et al.Intraoperative target-controlled infusion anesthesia application using remifentanil hydrochloride with etomidate in patients with severe burn as monitored using Narcotrend[J].Burns,2015,41(1):100-105.
[4]金成林.瑞芬太尼用于预防全身麻醉术后患者围拔管期不良反应的效果观察[J].中国现代药物应用,2017,11(9):122-123.
[5]刘广林,路志红,陈敏,等.中国西北部地区汉族患者麻醉药物相关基因多态性的分布[J].临床麻醉学杂志,2017(12):1149-1151.
[6]莫利群,曹露,吴刚明.靶控输注瑞芬太尼引起呼吸抑制的半数有效血浆靶浓度的研究[J].实用医院临床杂志,2015,12(01):74-76.
[7]刘利佳,王钟宇,金波,等.靶控输注瑞芬太尼半最大效应浓度的临床研究[J].实用药物与临床,2016,19(7):848-850.
[8] Hannam JA,Borrat X,Troconiz IF,et al.Modeling respiratory depression induced by remifentanil and propofol during sedation and analgesia using a continuous noninvasive measurement of pCO2[J].Journal of Pharmacology&Experimental Therapeutics,2015,356(3):563-573.
[9] Dahan A,Douma M,Olofsen E,et al.High inspired oxygen concentration increases the speed of onset of remifentanil-induced respiratory depression[J].British Journal of Anaesthesia,2016,116(6):879.
[10]彭粤,任从才,高新跃,等.瑞芬太尼呼吸抑制EC50与高强度聚焦超声热剂量的关系研究[J].海南医学,2012,23(5):9-11.
[11]姜卫荣,王金波,陈秀梅,等.胃癌根治术中瑞芬太尼复合丙泊酚的麻醉效果观察[J].中国临床医生,2016,44(7):49-51.
[12]冯建刚,石改萍,范勇民.不同剂量瑞芬太尼持续输注对小儿七氟烷麻醉下自主呼吸的影响[J].智慧健康,2017,3(25):84-85.
[13]张熙哲,吴新民.腰麻病人瑞芬太尼和舒芬太尼呼吸抑制的半数血浆靶浓度[J].中华麻醉学杂志,2007,27(1):58-61.
[14]徐兆景,王涛,徐昕明,等.不同海拔高度地区部队官兵高原驻训健康状况调查分析[J].西南国防医药,2016,26(3):344-346.
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