刘声苹首都医科大学附属北京潞河医：麻醉科，北京101149

    舒芬太尼静脉注射引起老年患者呼吸抑制的半数有效剂量

    刘声苹

    首都医科大学附属北京潞河医：麻醉科，北京101149

    目的测定老年患者单独注射舒芬太尼或给予小剂量咪达唑仑时引起呼吸抑制的半数有效剂量(ED50)。方法选择2014年10月～2015年10月于首都医科大学附属北京潞河医：择期拟行全麻腹部手术老年患者60例，年龄65～80岁。采用随机数字表法，将患者分为两组，每组各30例。S组给予单次静脉注射舒芬太尼，MS组先静脉注射咪达唑仑，5 min后再给予舒芬太尼。舒芬太尼剂量按序贯法确定，起始剂量分别为0.12 μg/kg和0.05 μg/kg，梯度剂量分别为0.01、0.005 μg/kg。MS组每例患者所用咪达唑仑的剂量为0.03 mg/kg。采用双盲法观察并记录患者的呼吸抑制情况，呼吸抑制的标准为SpO2≤92%和/或RR<10次/min。计算舒芬太尼的ED50及其95%可信区间(CI)。结果S组致呼吸抑制的ED50为0.13 μg/kg，95%CI为0.125～0.139 μg/kg。MS组致呼吸抑制的ED50为0.06 μg/kg，95%CI为0.057～0.063 μg/kg。结论老年患者单次单纯静脉注射舒芬太尼导致呼吸抑制的ED50为0.13 μg/kg，舒芬太尼伍用咪达唑仑时引起呼吸抑制的ED50降为0.06 μg/kg。

    舒芬太尼；咪达唑仑；呼吸抑制；半数有效剂量

    [Abstract]Objective To observe the median effective dose(ED50)of Sufentani1 intravenous injection a1one or combined with sma11 dose of Midazo1am for e1der1y patients.Methods 60 cases of e1der1y patients aged 65-80 underwent se1ected genera1 anesthesia abdomina1 operation in Beijing Luhe Hospita1,Capita1 Medica1 University from October 2014 to October 2015 were divided into two groups according to random number tab1e,each group had 30 cases.Group S was given Sufentani1 intravenous injection a1one,group MS was given Midazo1am intravenous injection first1y,5 min 1ater given Sufentani1.The dose of Sufentani1 was determined by up-and-down sequentia1 trai1.The initia1 dose was set at 0.12 μg/kg and 0.05 μg/kg in group S and group MS respective1y,the dosage gradient was 0.01,0.005 μg/kg.The dose of Midazo1am in group MS was 0.03 mg/kg.The respiratory depression situation was observed and recorded by doub1eb1ind method.The standard of respiratory depression was defined as SpO2≤92%and/or RR<10 times/min.ED50and 95%confidence interva1(CI)of respiratory depression was ca1cu1ated.Results The ED50and 95%CI of Sufentani1 caused respiratory depression was 0.13 μg/kg and 0.125-0.139 μg/kg in group S respective1y.The ED50and 95%CI in group MS was 0.06 μg/kg and 0.057-0.063 μg/kg.Conclusion The ED50of Sufentani1 intravenous injection a1one induced respiratory depression in e1der1y patients is 0.13 μg/kg.The ED50of Sufentani1 combined with Midazo1am is dec1ined to 0.06 μg/kg. ......