复合丙泊酚时阿芬太尼抑制患儿无痛皮肤磨削术中体动反应的半数有效剂量

Median effective dose of alfentanil combined with propofol for inhibiting intraoperative motor responses in children undergoing painless dermabrasion

中文关键词: 皮肤磨削术  半数有效剂量  阿芬太尼  儿童  麻醉

英文关键词: Dermabrasion  Median effective dose  Alfentanil  Child  Anesthesia

中文摘要:

      
目的 探讨复合丙泊酚时阿芬太尼抑制患儿无痛皮肤磨削术中体动反应的半数有效剂量（ED₅₀）。
方法 选择2021年7—11月择期行无痛皮肤磨削术患儿24例，男11例，女13例，年龄5～10岁，BMI 12～20 kg/m²，ASA Ⅰ或Ⅱ级。所有患儿均给予丙泊酚2 mg/kg复合阿芬太尼静脉麻醉。采用Dixon序贯法进行研究，阿芬太尼初始剂量10 μg/kg，下一例患儿剂量由上一例患儿体动反应决定，若术中体动反应阳性，下一例患儿阿芬太尼剂量增加1 μg/kg；若术中体动反应阴性，则下一例患儿阿芬太尼剂量减少1 μg/kg，重复此过程直到出现7个拐点终止研究。采用Probit法计算阿芬太尼的ED₅₀、95%有效剂量（ED₉₅）及其95%可信区间（CI）。
结果 复合丙泊酚时阿芬太尼抑制体动反应的ED₅₀为9.58 μg/kg（95%CI 8.97～10.21 μg/kg），ED₉₅为10.74 μg/kg（95%CI 10.12～14.01 μg/kg）。
结论 复合丙泊酚2 mg/kg时阿芬太尼用于患儿无痛皮肤磨削术的ED₅₀为9.58 μg/kg(95%CI 8.97~10.21 μg/kg)。

英文摘要:

      
Objective To evaluate the median effective dose (ED₅₀) of alfentanil combined with propofol for inhibiting intraoperative motor responses in children undergoing painless dermabrasion.
Methods Twenty-four children undergoing painless dermabrasion were selected from July 2021 to November 2021, 11 males and 13 females, aged 5-10 years, BMI 12-20 kg/m², ASA physical status Ⅰ or Ⅱ. Propofol 2 mg/kg combined with alfentanil was given in all children undergoing painless dermabrasion. The dose of alfentanil was determined by the Dixon up-down method, the initial dose of alfentanil was 10 μg/kg. The dose of alfentanil in the next child was determined according to the development of body-moving. If body-moving occurred, the next case was given a higher-level dose (add alfentanil 1 μg/kg), if body-moving did not occurred, the next case was given a lower-level dose (reduce alfentanil 1 μg/kg), repeat this process until the seventh exchange point appeared to completed the study. The ED₅₀, 95% effective dose (ED₉₅) and 95% confidence interval (CI) of alfentanil combined with propofol in children undergoing painless dermabrasion were calculated using Probit method.
Results The ED₅₀ of alfentanil combined with propofol was 9.58 μg/kg (95% CI 8.97-10.21 μg/kg), and the ED₉₅ of alfentanil combined with propofol was 10.74 μg/kg (95% CI 10.12-14.01 μg/kg) in children undergoing painless dermabrasion.
Conclusion The ED₅₀ of alfentanil combined with propofol 2 mg/kg were 9.58 μg/kg (95% CI 8.97~10.21 μg/kg) in children undergoing painless dermabrasion.