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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

26卷

期数:

2020年04期

页码:

383-385

栏目:

临床医学

出版日期:

2020-07-15

文章信息/Info

Title:

Effects of butorphanol on ED95 of etomidate for loss of consciousness

文章编号:

1006-8147(2020)04-0383-03

作者:

王莹; 辛曙辉

（天津医科大学第二医院麻醉科，天津 300211）

Author(s):

WANG Ying;  XIN Shu-hui

（Department of Anesthesiology, The Second Hospital, Tianjin Medical University, Tianjin 300211, China)

关键词:

布托啡诺; 依托咪酯; 意识消失; 药效学

Keywords:

butorphanol;  etomidate;  loss of consciousness;  pharmacodynamic

分类号:

R614

DOI:

-

文献标志码:

A

摘要:

目的：探讨15 μg/kg布托啡诺对依托咪酯致患者意识消失95%有效剂量（ED95）的影响。方法：择期行无痛肠镜检查患者80例，性别不限，年龄42~60岁，美国麻醉医师协会（ASA）分级I或II级。将患者随机分为两组：依托咪酯组（E组）、依托咪酯复合布托啡诺15 μg/kg组（EB组）。EB组患者予静脉注射重酒石酸布托啡诺15 μg/kg，3 min后按偏性掷币序贯法给予依托咪酯，首剂量为0.04 mg/kg，相邻剂量差0.04 mg/kg，E组采用相同容量生理盐水代替，依托咪酯的给予方式与EB组相同。应用保序回归和合并相邻者算法计算依托咪酯致患者意识消失的ED95，通过Bootstrap重复抽样法计算95%CI。结果：E组依托咪酯致患者意识消失的ED95及其95%CI为0.220（0.190~0.262） mg/kg，EB组中依托咪酯致患者意识消失的ED95为0.159（0.125~0.179） mg/kg。EB组依托咪酯致患者意识消失的ED95明显低于E组（P<0.05）。EB组肌阵挛的发生率明显低于E组（P<0.05）。结论：预注布托啡诺15 μg/kg可明显降低依托咪酯致患者意识消失的ED95，同时可降低依托咪酯所致肌阵挛的发生率。

Abstract:

Objective: To determine the effects of butorphanol of 15 μg/kg on 95% effective dose(ED95) of etomidate for loss of consciousness.Methods:A total of 80 patients undergoing painless colonoscopy were studied, male or female,aged 42 to 60 years old, and American association of anesthesiologists (ASA) grade Ⅰ or Ⅱ. These patients were allocated to two groups in accordance with the random number table:etomidate alone (Group E), or etomidate combined with butorphanol of 15 μg/kg for intravenous premedication(Group EB).For Group EB,15 μg/kg of butorphanol were intravenously injected, and after 3 minutes the etomidate dosage was determined using the biased coin design up-and-down sequential method. The first dose of etomidate was 0.04 mg/kg, and the adjacent dose gradient was 0.04 mg/kg. For Group E, butorphanol was replaced by normal saline of the same volume, and the etomidate dosage was determined in the same way as Group EB. ED95 of etomidate for loss of consciousness of every group was determined by the isotonic regression with pooled adjacent violators algorithm separately. The bootstrap was used to estimate the confidence interval(95%CI) of ED95. Results: ED95 and the 95% CI of etomidate for loss of consciousness was 0.220(0.190-0.262)mg/kg in Group E, 0.159(0.125-0.179) mg/kg in Group EB. The ED95 of etomidate for loss of consciousness in Group EB was significantly lower than that in Group E(P<0.05). Compared with Groups E, the incidence of myoclonus was lower in Group EB(P<0.05). Conclusion: Butorphanol of　15 μg/kg for intravenous premedication can significantly reduce the ED95 of etomidate for loss of consciousness and the incidence of myoclonus.

参考文献/References:

[1] 邓小明，姚尚龙，于布为，等. 现代麻醉学[M]. 第四版. 人民卫生出版社, 2014: 509-509
[2] Hua J, Miao S, Shi M, et al. Effect of butorphanol on etomidate-induced myoclonus: a systematic review and meta-analysis[J]. Drug Des Devel Ther, 2019, 13:1213
[3] 张婧，刘玲，吕国义. 预先静注布托啡诺与地佐辛抑制依托咪酯所致肌阵挛效应的比较[J]. 天津医药, 2015, 43(12):1450
[4] Pace N L, Stylianou M P. Advances in and limitations of up-and-down methodology: a precis of clinical use, study design, and dose estimation in anesthesia research[J]. Anesthesiology, 2007, 107(1):144
[5 王彬，程庆好，李蕾，等. 靶控输注依托咪酯意识消失的半数有效量的测定[J]. 中华全科医学, 2015, 13(2):202
[6] 李旭，董有静，吴迪. 近日节律对依托咪酯致老年患者意识消失作用的影响[J]. 实用药物与临床, 2016,19(1):38
[7] Macgregor-Fors I, Payton M E. Contrasting diversity values: statistical inferences based on overlapping confidence intervals[J]. PLoS One, 2013, 8(2): e56794
[8] Devlin R J, Kalil D. Etomidate as an induction agent in sepsis[J]. Crit Care Nurs Clin North Am, 2018,30(3):e1
[9] He L, Ding Y, Chen H, et al. Butorphanol pre-treatment prevents myoclonus induced by etomidate: a randomised, double-blind, controlled clinical trial[J]. Swiss Med Wkly, 2014, 144:w14042
[10] 任杰，兰萍，袁瑞梅. 布托啡诺预处理对依托咪酯全麻诱导时诱发肌阵挛的影响[J]. 山东医药, 2013, 53(48):58
[11] 徐鹏，蔡雪峰，陈星，等. 预注布托啡诺对无痛胃镜依托咪酯所致肌阵挛的影响[J]. 临床麻醉学杂志, 2013, 29(5):510
[12] 王莹，辛曙辉. 不同剂量右美托咪定对依托咪酯致患者意识消失ED(95)的影响[J]. 临床麻醉学杂志, 2019, 35(12):1157
[13] George R B, Mckeen D, Columb M O, et al. Up-down determination of the 90% effective dose of phenylephrine for the treatment of spinal anesthesia-induced hypotension in parturients undergoing cesarean delivery[J]. Anesth Analg, 2010, 110(1):154
[14] Fang G, Wan L, Mei W, et al. The minimum effective concentration (MEC90) of ropivacaine for ultrasound-guided supraclavicular brachial plexus block[J]. Anaesthesia, 2016, 71(6):700
[15] Saranteas T, Finlayson R J, Tran D Q. Dose-finding methodology for peripheral nerve blocks[J]. Reg Anesth Pain Med,2014,39(6):550

相似文献/References:

[1]许德芳,余剑波,牟 戎,等.不同全麻药物对体外循环患者氧化应激反应影响的比较[J].天津医科大学学报,2015,21(04):328.
　XU De-fang,YU Jian-bo,MU Rong,et al.Effect of different anesthesia on perioperative oxidative stress in patients with coronary artery bypass grafting[J].Journal of Tianjin Medical University,2015,21(04):328.

备注/Memo

备注/Memo:

作者简介 王莹（1987-），男，医师，硕士，研究方向：麻醉药物临床与基础；
通信作者：辛曙辉，E-mail: xshys2012@163.com。

常用功能

更新日期/Last Update: 2020-07-15