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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 51 -53. doi: 10.3877/cma.j.issn.1674-392X.2019.01.014

所属专题： 文献；

论著

全麻下抑制小儿疝修补术体动反应的瑞芬太尼效应室浓度探讨
赵三军1,†(), 张宏强2, 肖剑锐3, 陆东东4, 程庆春1   
  1. 1. 071000　河北保定，解放军第82集团军医院麻醉科
    2. 071000　河北保定，解放军第82集团军医院耳鼻喉科
    3. 071000　河北保定，解放军第82集团军医院口腔科
    4. 714000　陕西渭南，32144部队卫生连
  • 收稿日期:2018-06-01 出版日期:2019-02-18
  • 通信作者: 赵三军

Study on effect chamber concentration of remifentanil inhibiting the body motion response of children undergoing hernia repair under general anesthesia

Sanjun Zhao1,†(), Hongqiang Zhang2, Jianrui Xiao3, Dongdong Lu4, Qingchun Cheng1   

  1. 1. Department of Anesthesiology, the 82nd Group Military Hospital of PLA, Baoding 071000, China
    2. ENT, the 82nd Group Military Hospital of PLA, Baoding 071000, China
    3. Stomatology, the 82nd Group Military Hospital of PLA, Baoding 071000, China
    4. Health company of 32144 troops, Weinan 714000, China
  • Received:2018-06-01 Published:2019-02-18
  • Corresponding author: Sanjun Zhao
  • About author:
    Corresponding author: Ultrastructural, Email:
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赵三军, 张宏强, 肖剑锐, 陆东东, 程庆春. 全麻下抑制小儿疝修补术体动反应的瑞芬太尼效应室浓度探讨[J]. 中华疝和腹壁外科杂志(电子版), 2019, 13(01): 51-53.

Sanjun Zhao, Hongqiang Zhang, Jianrui Xiao, Dongdong Lu, Qingchun Cheng. Study on effect chamber concentration of remifentanil inhibiting the body motion response of children undergoing hernia repair under general anesthesia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(01): 51-53.

目的

探讨小儿疝修补术患者非肌松条件下使用瑞芬太尼抑制术中体动反应的有效效应室浓度。

方法

选择2017年1月至2018年2月，解放军第82集团军医院择期行疝修补术的患儿28例（年龄<12岁），ASA分级Ⅰ或Ⅱ级。麻醉诱导和维持采用丙泊酚（Marsh模型）和瑞芬太尼（Minto模型），BIS控制在45～55。初始瑞芬太尼效应室浓度为4.0 ng/ml，根据患儿术中有无出现阳性反应（无体动反应）和Dixon up-and-down方法调节下一例患儿瑞芬太尼效应室靶浓度，调节幅度为0.2 ng/ml。经历7次阳性-阴性反应交叉，并根据阴性-阳性反应配对的平均值和probit回归计算EC50、EC95（effective concentration）。

结果

瑞芬太尼抑制小儿疝修补术中体动的效应室浓度为3.99 ng/ml，经probit回归分析，EC50和EC95为3.90 ng/ml和4.34 ng/ml。

结论

无肌松条件下实施小儿疝修补术时，瑞芬太尼效应室浓度达到3.90 ng/ml和4.34 ng/ml时，分别有50%和95%可能性抑制患儿的体动反应。

关键词: 疝修补术, 瑞芬太尼, 儿童, 体动反应
Objective

To investigate the effective concentration of remifentanil inhibiting the body movement in children undergoing hernia repair with no muscle relaxation.

Methods

From January 2017 to February 2018, twenty-eight children (age<12 years old) underwent selective hernia repair and ASA grade I or II in the 82nd Group Military Hospital of PLA were enrolled. Anesthesia induction and maintenance were performed with propofol (Marsh model) and remifentanil (Minto model). BIS was controlled ranging from 45 to 55. The initial effect chamber concentration of remifentanil was 4.0 ng/ml and the next patient's target effect chamber concentration of remifentanil was adjusted according to the positive reaction (no body motion response) in the former child and Dixon up-and-down method, with an adjustment range of 0.2 ng/ml. After seven negative-positive reaction crossovers, the EC50 and EC95 (effective concentration) were calculated based on the mean of the negative-positive reaction pair and Probit regression.

Results

The EC50 of remifentanil in the inhibition of body movement in children undergoing hernia repair was 3.99 ng/ml. The EC50 and EC95 were 3.90 ng/ml and 4.34 ng/ml, respectively, by Probit regression analysis.

Conclusion

The EC50 and EC95 of the effect chambers inhibiting the body motion of children undergoing hernia repair were 3.90 ng/ml and 4.34 ng/ml.

Key words: Hernia repair, Remifentanil, Children, Body motion
图1 不同瑞芬太尼效应室浓度下的序贯实验，其中箭头所示为每一个阴性-阳性反应配对的平均值
图2 不同瑞芬太尼效应室浓度下发生阳性反应（无体动）的概率
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