中华麻醉学杂志2024,Vol.44Issue(12) :1446-1449.DOI:10.3760/cma.j.cn131073.20241022.01209

复合丙泊酚时奥赛利定用于人工流产术患者镇痛的半数有效剂量

Median effective dose of oliceridine combined with propofol for analgesia during induced abortion

李雨虹 孟凡 仇佳 尹宁
中华麻醉学杂志2024,Vol.44Issue(12) :1446-1449.DOI:10.3760/cma.j.cn131073.20241022.01209

复合丙泊酚时奥赛利定用于人工流产术患者镇痛的半数有效剂量

Median effective dose of oliceridine combined with propofol for analgesia during induced abortion

李雨虹 1孟凡 1仇佳 1尹宁1
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作者信息

  • 1. 南京医科大学附属逸夫医院麻醉科,南京 221000
  • 折叠

摘要

目的 确定复合丙泊酚时奥赛利定用于人工流产术患者镇痛的半数有效剂量(ED50).方法 本研究为前瞻性研究.选择2024年9月至10月南京医科大学附属逸夫医院计划生育室行人工流产术的患者,年龄20~45岁,BMI 18~26 kg/m2,ASA分级Ⅰ或Ⅱ级.采用改良Dixon序贯法进行试验,奥赛利定初始剂量0.025 mg/kg,2 min后静脉注射丙泊酚2 mg/kg,奥赛利定相邻药物剂量比为1.0:1.1.若扩张宫颈时镇痛不足(皱眉、呻吟、不自主地肢体运动,HR或MAP增加幅度>基线值的20%),则下一例患者奥赛利定剂量上调一个梯度,反之,则下调一个梯度,出现7个镇痛不足转镇痛充分的转折点时终止研究.使用Dixon序贯试验公式计算奥赛利定的ED50及95%置信区间(CI).记录术中低氧血症、术后头晕和恶心呕吐等不良反应的发生情况.结果 本研究共纳入患者24例,复合丙泊酚2 mg/kg时,奥赛利定用于人工流产术镇痛的ED50为0.019 mg/kg,95%CI为0.018~0.021 mg/kg.1例患者发生低氧血症,2例术后轻度头晕,所有患者未见恶心呕吐发生.结论 复合2 mg/kg丙泊酚时奥赛利定用于人工流术患者镇痛的ED50为 0.019 mg/kg.

Abstract

Objective To determine the median effective dose(ED50)of oliceridine for analgesia during induced abortion when combined with propofol.Methods In this prospective study,24 American So-ciety of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients,aged 20-45 yr,with a body mass index of 18-26 kg/m2,who underwent painless induced abortion surgery at Sir Run Run Hospital affiliated to Nan-jing Medical University from September to October 2024,were selected.The modified Dixon sequential method was used for the study.The initial dose of oliceridine was 0.025 mg/kg,and 2 min later propofol 2 mg/kg was intravenously injected.The ratio between the two successive doses of oliceridine was 1.0:1.1.If the patient experienced inadequate analgesia during cervical dilation(frowning,moaning,involuntary limb movements,increase in heart rate or mean arterial pressure greater than 20%of baseline),the next patient received a higher dose of oliceridine,or conversely,a lower dose was given.The study was terminated when 7 turning points from inadequate analgesia to adequate analgesia were achieved.Dixon sequential trial formula was used to calculate the ED50 of oliceridine and the confidence interval.The occurrence of adverse reactions such as in-traoperative hypoxemia,postoperative dizziness and nausea and vomiting was recorded.Results Twenty-four patients were ultimately included in this study.When combined with propofol 2 mg/kg,the ED50 of oliceri-dine for analgesia during painless induced abortion surgery was 0.019 mg/kg(95%confidence interval 0.018-0.021 mg/kg).One patient developed hypoxemia,and two patients experienced mild dizziness after surgery.All patients had no nausea or vomiting.Conclusions When combined with 2 mg/kg of propofol,the ED50 of oliceridine for analgesia during is 0.019 mg/kg induced abortion surgery.

关键词

镇痛药,阿片类/二异丙酚/流产,人工/剂量效应关系,药物

Key words

Analgesics,opioid/Propofol/Abortion,induced/Dose-response relationship,drug

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出版年

2024
中华麻醉学杂志
中华医学会

中华麻醉学杂志

CSTPCDCSCD北大核心
影响因子:1.235
ISSN:0254-1416
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