环泊酚用于老年患者椎管内麻醉辅助镇静的药效学
Pharmacodynamics of ciprofol for adjunctive sedation in elderly patients undergoing neuraxial anes-thesia
李波 1岳维 2田彦东 1熊明兴 1高颖1
作者信息
- 1. 山西医科大学麻醉学院,太原 030001
- 2. 山西医科大学第二医院麻醉科,太原 030001
- 折叠
摘要
目的 确定环泊酚用于老年患者椎管内麻醉辅助镇静的药效学.方法 本研究为前瞻性研究.选择山西医科大学第二医院2023年6月至9月椎管内麻醉下行择期膝关节置换术患者.年龄≥65岁,BMI 18～30 kg/m2,ASA分级Ⅰ-Ⅲ级.椎管内麻醉完成后,静脉泵注环泊酚,负荷剂量0.05 mg/kg(给药时间约4 min).采用序贯法确定维持剂量,初始维持剂量为0.2 mg·kg-1·h-1,剂量梯度为0.02 mg·kg-1·h-1.镇静满意则下一例患者环泊酚给药剂量下降一级;镇静不满意,下一例患者环泊酚给药剂量上升一级,发生8次转折后结束试验.记录给药及苏醒期间不良反应发生情况.采用probit概率回归法计算环泊酚的半数有效剂量(ED50)、95％有效剂量(ED95)及其95％可信区间(CI).结果 共纳入35例患者.环泊酚用于老年患者椎管内麻醉辅助镇静的ED50为 0.246 mg·kg-1 h-1(95％CI 0.217～0.300 mg·kg-1·h-1),ED95为 0.325 mg·kg-1·h-1(95％CI 0.284～0.771 mg·kg-1·h-1).环泊酚给药期间,发生心动过缓4例(11％)、低血压2例(6％)、低氧血症2例(6％),经处理后均改善;均未见注射痛、异常肢体运动、苏醒期躁动、头晕、头痛、恶心呕吐、术后谵妄发生.结论 环泊酚用于椎管内麻醉老年患者辅助镇静的ED50为 0.246 mg·kg-1·h-1,ED95为0.325 mg·kg-1·h-1.
Abstract
Objective To determine the pharmacodynamics of ciprofol for adjunctive sedation in elderly patients undergoing neuraxial anesthesia.Methods This was a prospective study.American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex,aged ≥65 yr,with a body mass index of 18-30 kg/m2,scheduled for elective knee replacement under neuraxial anesthesia from June to Sep-tember 2023 in the Second Hospital of Shanxi Medical University,were selected.After completion of neuraxial anesthesia,ciprofol was pumped intravenously at a loading dose of 0.05 mg/kg(administered for approximate-ly 4 min).The maintenance dose was determined by the sequential method.The initial maintenance dose was 0.2 mg·kg-1·h-1,and the dose gradient was 0.02 mg·kg-1·h-1.If the patient was satisfactorily sedated,the dose of ciprofol was decreased by 0.02 mg·kg-1·h-1 in the next patient;if the sedation was unsatisfacto-ry,the dose of ciprofol was increased by 0.02 mg·kg-1·h-1 in the next patient,and the trial was terminated after 8 transitions.The occurrence of adverse reactions was recorded during administration and emergence.The median effective dose(ED50),95％effective dose(ED95)and the corresponding 95％confidence interval(CI)of ciprofol were calculated using the probit regression analysis.Results Thirty-five patients were finally included in this study.The ED50 of ciprofol for adjunctive sedation was 0.246 mg·-1 kg-1·h-1(95％CI 0.217-0.300 mg·kg-1·h-1),and the ED95 was 0.325 mg·kg-1·h-1(95％CI 0.284-0.771 mg·kg-1·h-1)in elderly patients undergoing knee arthroplasty under neuraxial anesthesia.During the ad-ministration of ciprofol,bradycardia occurred in 4 cases(11％),hypotension in 2 cases(6％),and hypox-emia in 2 cases(6％),which improved after treatment.No injection pain,abnormal limb movements,agi-tation during emergence,dizziness,headache,nausea and vomiting and postoperative delirium developed in patients.Conclusions The ED50 of ciprofol for adjunctive sedation is 0.246 mg·kg-1·h-1 and the ED95 is 0.325 mg·kg-1·h-1 in elderly patients undergoing neuraxial anesthesia.
关键词
环泊酚/老年人/麻醉,脊椎/清醒镇静/剂量效应关系,药物Key words
Ciprofol/Aged/Anesthesia,spinal/Conscious sedation/Dose-response rela-tionship,drug引用本文复制引用
出版年
2024
NETL
NSTL
万方数据