艾司氯胺酮和丙泊酚在宫腔镜手术中的药效学相互作用

Pharmacodynamic interaction of esketamine and propofol in hysteroscopic surgery

中文关键词: 艾司氯胺酮  丙泊酚  药效学相互作用  响应曲面法  靶控输注

英文关键词: Esketamine  Propofol  Response surface methodology  Pharmacodynamic interaction  Target-controlled infusion

中文摘要:

      
目的：采用响应曲面法分析艾司氯胺酮和丙泊酚在宫腔镜手术中的药效学相互作用。
方法：选择择期行宫腔镜手术患者45例，年龄18~64岁，BMI 18.5～28.0 kg/m²，ASA Ⅰ或Ⅱ级。选择不同血浆药物浓度的艾司氯胺酮（0、0.1、0.2、0.3、0.4、0.5、0.6、0.7、0.8 μg/ml）复合丙泊酚靶控输注，术中维持艾司氯胺酮的血浆药物浓度不变，阶梯式增加丙泊酚的血浆药物浓度。评估扩张宫颈引起的体动反应。采用响应曲面模型分析艾司氯胺酮与丙泊酚的药效学相互作用。
结果：艾司氯胺酮（0～0.8 μg/ml）与丙泊酚（1.0～7.0 μg/ml）相互作用的三维响应曲面显示，两者抑制扩张宫颈引起的体动反应方面具有相加作用。抑制扩张宫颈引起的体动反应的艾司氯胺酮半数有效浓度（EC₅₀）为0.61 μg/ml（95%CI 0.41～0.81 μg/ml），丙泊酚EC₅₀为4.69 μg/ml（95%CI 3.17～6.21 μg/ml）。
结论：响应曲面法可以定性和定量地分析艾司氯胺酮和丙泊酚的药效学相互作用规律，在抑制扩张宫颈引起的体动反应上，艾司氯胺酮和丙泊酚具有相加作用。

英文摘要:

      
Objective: To analyze the pharmacodynamic interaction of esketamine and propofol in hysteroscopic surgery by response surface method.
Methods: Forty-five patients underwent elective hysteroscopic surgery, aged 18.5-64.0 years, BMI 18.5-28.0 kg/m², ASA physical status Ⅰ or Ⅱ. Compound propofol target control infusion of esketamine (0, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, and 0.8 μg/ml) with different plasma drug concentrations were selected to keep the plasma drug concentration of esketamine unchanged, and the plasma drug concentration of propofol was increased step by step. To evaluate body response caused by dilation of the cervix. A response surface model was used to analyze the pharmacodynamic interaction of esketamine and propofol.
Results: The three-dimensional response surface of esketamine (0.0-0.8 μg/ml) and propofol (1.0-7.0 μg/ml) showed that the two have an additive effect in sedation and inhibition of body activity reaction caused by dilated cervix. The median effective concentration (EC₅₀) of esketamine was 0.61 μg/ml (95% CI0.41-0.81 μg/ml), and the EC₅₀ of propofol was 4.69 μg/ml (95% CI3.17-6.21 μg/ml) when inhibits the body activity reaction caused by dilated cervix.
Conclusion: Response surface method can qualitatively and quantitatively analyze the pharmacodynamic interaction of esketamine and propofol. Esketamine and propofol have additive effects in inhibiting the body activity reaction caused by dilated cervix．