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[1]̷???,?? ??.???̫??Ѫ??Ũ?ȶ?????????????Ч?ܵ?Ӱ??[J].ҽѧ??Ϣ,2020,(15):103-105.[doi:10.3969/j.issn.1006-1959.2020.15.031]
??TAN Bin-bin,CHEN Jun.The Effect of Plasma Concentration of Remifentanil on the Anesthetic Efficacy of Etomidate[J].Medical Information,2020,(15):103-105.[doi:10.3969/j.issn.1006-1959.2020.15.031]
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ҽѧ??Ϣ[ISSN:1006-1959/CN:61-1278/R]

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2020??15??
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103-105
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?ٴ??о?
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2020-08-01

??????Ϣ/Info

Title:
The Effect of Plasma Concentration of Remifentanil on the Anesthetic Efficacy of Etomidate
???±??:
1006-1959??2020??15-0103-03
????:
̷????? ??
????л???ҽԺ?????ƣ???? 300060
Author(s):
TAN Bin-binCHEN Jun
Department of Anesthesiology,Tianjin Huanhu Hospital,Tianjin 300060,China
?ؼ???:
???????? ???̫?? ?п???ע
Keywords:
EtomidateRemifentanilTarget-controlled infusion
?????:
R614.2
DOI:
10.3969/j.issn.1006-1959.2020.15.031
???ױ?־??:
A
ժҪ:
Ŀ?? ?о??п???ע??ͬѪ??Ũ?????̫???????????????Ч?ܵ?Ӱ?졣???? ѡ??2018??12??~2019??10????Ժ????ȫƾ???????????о??ڶ?????Ĥ??????????80????Ϊ?о????󣬰?????????ֱ????????ΪR0??R1??R2??R3???飬R0?鲻ʹ?????̫?ᣬR1??R2??R3?յ???ʼʱ?Ȱп???ע???̫????Ѫ????Ũ??Ϊ1??2??3 ng/ml??????Ѫ??Ũ??0.5 ??g/mlΪ??㿪ʼ?п???ע???????????˺?ÿ??????????????????Ѫ????Ũ??0.1 ??g/mlֱ????????ʶ??ʧ???Ե?̼??嶯??Ӧ??ʧ???Ƚ?????????ʱ?????̫????Ũ??ʱ????ʶ??ʧʱ????ʹ?̼???Ӧ??ʧʱ???ʣ?HR????ƽ??????ѹ??MAP??????¼??????ʶ??ʧ??????ʹ?̼??嶯??Ӧ??ʧʱ??????????Ѫ??Ũ?ȼ??Ե?˫Ƶ??ָ????BIS??ֵ??ͨ??Probit??????????????Ѫ??Ũ?ȵİ?????ЧŨ?ȣ?EC50???ͻ??ߵİ?????˯BISֵ??BIS50??????? ??R1????ʹ?̼??嶯??Ӧ??ʧʱ??MAP??HR??????ʶ??ʧʱ????????ͳ??ѧ???壨P??0.05??????ʶ??ʧʱ??R3??HR????R0?飬??????ͳ??ѧ???壨P??0.05??????ʹ?̼??嶯??Ӧ??ʧʱ??R3??MAP??HR????R1?飬??????ͳ??ѧ???壨P??0.05????????ʶ??ʧʱ??R0??R1??R2??R3????????????EC50?ֱ?Ϊ0.80 ??g/ml??0.72 ??g/ml??0.65 ??g/ml??0.58 ??g/ml??BIS50?ֱ?Ϊ47??50??45??47????ʹ?̼??嶯??Ӧ??ʧʱ??R1??R2??R3????????????EC50?ֱ?Ϊ0.94 ??g/ml??0.84 ??g/ml??0.72 ??g/ml??BIS50?ֱ?Ϊ54??49??52?????? ?п???ע1??2??3 ng/ml?????̫????Գʼ????????Եؽ?????????????ʶ??ʧ????ʹ?̼??嶯??Ӧ??ʧʱ????????????Ѫ??Ũ?ȵ?EC50???????????????????Ч?ܣ????⣬???߶???ʹ?̼??嶯??Ӧ??ʧʱ??BIS50????ʶ??ʧʱ??????????
Abstract:
Objective To study the effect of target-controlled infusion of different plasma concentrations of remifentanil on the anesthetic efficacy of etomidate.Methods From December 2018 to October 2019, 80 patients with internal carotid endarterectomy under total intravenous anesthesia in our hospital were selected as the research objects, and they were divided into R0, R1, R2, R3 according to the random number table method four groups, R0 group did not use remifentanil, at the beginning of R1, R2, and R3 induction, remifentanil was first target-controlled infusion to the plasma target concentration of 1, 2, 3 ng/ml, and then the plasma concentration was 0.5 ??g/ml the target-controlled infusion of etomidate was started with ml as the starting point, and the target plasma concentration of etomidate was increased by 0.1 ??g/ml every minute until the patient??s consciousness disappeared and the body response to electrical stimulation disappeared. Compare the heart rate (HR) and mean arterial pressure (MAP) when the four groups enter the room, when the target concentration of remifentanil reaches the target concentration, when the consciousness disappears, and when the pain response disappears. Record the four groups when the consciousness disappears and the body movement response to the pain stimulation disappears the plasma concentration of etomidate and the bispectral index (BIS) value of etomidate were calculated by the Probit method to calculate the half effective concentration (EC50) of etomidate plasma concentration and the BIS value (BIS50) of half of patients falling asleep. Results ??The MAP and HR of the R1 group when the pain stimulus disappeared were higher than when the consciousness disappeared, the difference was statistically significant (P??0.05); when the consciousness disappeared, the HR of the R3 group was lower than the R0 group, the difference was statistically significant (P??0.05); when the painful stimulation disappeared, the MAP and HR of the R3 group were lower than those of the R1 group, the difference was statistically significant (P<0.05). ??When consciousness disappeared, the EC50 of etomidate in the R0, R1, R2, and R3 groups were 0.80 ??g/ml, 0.72 ??g/ml, 0.65 ??g/ml and 0.58 ??g/ml, respectively, and the BIS50 were 47, 50, 45, 47, respectively; The EC50 of etomidate in groups R1, R2, and R3 were 0.94 ??g/ml, 0.84 ??g/ml, and 0.72 ??g/ml when the body movement response to pain stimulation disappeared, and the BIS50 was 54, 49, and 52, respectively.Conclusion Target-controlled infusion of 1 ng/ml, 2 ng/ml, and 3 ng/ml remifentanil can dose-dependently reduce etomidate plasma concentration in patients undergoing surgery with disappearance of consciousness and painful stimuli. The EC50 improves the anesthetic efficacy of etomidate; in addition, the BIS50 of the patient when the patient??s body response to painful stimulation disappears is higher than when the consciousness disappears.

?ο?????/References:

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????????/References:

[1]???컪,Ҷ???,??????.??֢???껼????ʹθ???????????Ч???о?[J].ҽѧ??Ϣ,2018,(08):84.[doi:10.3969/j.issn.1006-1959.2018.08.026]
??XU Tian-hua,YE Miao-en,MA Li-jing.Study on Anesthesia Effect of Painless Gastroenteroscopy in the Elderly Patients with Severe Cases[J].Medical Information,2018,(15):84.[doi:10.3969/j.issn.1006-1959.2018.08.026]

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