Dose finding study of cisatracurium for laryngeal mask insertion in patients undergoing uret-eroscopic laser lithotripsy
Objective To evaluated the 50％effective dose(ED50)and 95％effective dose(ED95)of cisatracurium for laryngeal mask insertion in patients undergoing ureteroscopic laser litho-tripsy.Methods A total of 50 patients who planned to undergo ureteroscopic laser lithotripsy in our hospital from January 2020 to February 2021 were selected.Dixon sequential method was used to ad-just the drug dose of cisatracurium,and the drug dose gradient was 0.15,0.125,0.1,0.075,0.05,0.025,0.0125 mg/kg.If the laryngeal mask was successfully inserted in the previous patient,the ci-satracurium dose was lowered by a gradient in the next patient.If laryngeal mask placement failed in the previous patient,cisatracurium dose was increased by a gradient in the next patient.The total num-ber of patients with cisatracurium at each dose and the number of successful laryngeal mask placement were recorded for calculation of ED50 and ED95.According to the values of ED50 and ED95 and the sample size of each dose,the doses of cisatracurium 0.05 mg/kg,0.025 mg/kg and 0.0125 mg/kg were divided into cisatracurium 0.05 mg/kg group(C0.05 group,8 cases),cisatracurium 0.025 mg/kg group(C0.025 group,22 cases)and cisatracurium 0.0125 mg/kg group(C0.0125 group,15 cases).Train of four stimulation(TOF)of patients were recorded before injection of cisatracurium(T0),3 min after injection of cisatracurium(T1),and immediately after laryngeal mask insertion(T2)and peak airway pressure at T2.The adverse reactions such as pharyngeal pain,blood stained laryngeal mask,hoarseness and laryngeal spasm after laryngeal mask removal were recorded.Results Probit re-gression was used to calculate ED50 and ED95,and the results showed that the ED50 and ED95 of la-ryngeal mask insertion with cisatracurium were 0.025 mg/kg and 0.045 mg/kg,respectively.TOF(T4/T1)at T1 in C0.0125 group was significantly higher than that in C0.025 group and C0.05 group,the difference was statistically significant(all P＜0.05).The peak at T2 in the C0.025 group was signifi-cantly higher than that in the C0.0125 and C0.05 groups,and the difference was statistically significant(all P＜0.05).There was no significant difference in the incidence of intraoperative laryngeal mask displacement,pharyngeal pain and hoarseness among the three groups(P＞0.05).The incidence of blood stained laryngeal mask in C0.05 group was lower than that in C0.025 group and C0.0125 group,but the difference was not statistically significant(P=0.063).Conclusions The ED50 and ED95 of ci-satracurium for laryngeal mask insertion in ureteroscopic laser lithotripsy were 0.025 mg/kg(95％CI:0.010-0.030)and 0.045 mg/kg(95％CI:0.030-0.060).
NETL
NSTL
万方数据
维普
