喉罩气道(LMA)已广泛应用于临床。在插入喉罩期间对患者的刺激会导致血液动力学波动,这对老年患者尤其不安全。我们使用probit回归分析来确定舒芬太尼抑制老年患者对LMA插入反应的中位有效剂量。
共选择90例患者进行研究,纳入标准如下:年龄≥65岁,ASAI-III级,并计划进行LMA插入静脉全身麻醉。每位患者接受了6个水平之一的舒芬太尼用于麻醉诱导:0.05、0.1、0.15、0.2、0.25或0.3μgkg-1。LMA插入得分为3分,6类量表,分数≥16表示有效的LMA插入,和<16指示无效的LMA插入。平均动脉血压(MAP),心率(HR),和脑电双频指数(BIS)记录在诱导前1分钟(T1),诱导后1分钟(T2),LMA插入后1分钟(T3),每组插入LMA后5分钟(T4)。此外,测定各剂量组T2和T3时的血浆去甲肾上腺素(NE)水平和不良反应.
Probit回归分析表明,舒芬太尼抑制老年患者LMA插入反应的ED50为0.18μgkg-1(95%CI:0.16-0.21μgkg-1),ED95为0.31μgkg-1(95%CI:0.27-0.38μgkg-1),和概率(p)=-2.34+12.90×ln(剂量)([公式:见文本]=0.725,p=0.948)。在所有的病人中,有效的LMA插入数为57(A组),无效的LMA插入数为33(B组)。地图,HR,T3时B组NE明显高于A组。
舒芬太尼能有效抑制患者对LMA插入的反应,具有稳定的血流动力学和小的应激反应。ED50和ED95分别为0.18μgkg-1(95%CI:0.16-0.21μgkg-1)和0.31μgkg-1(95%CI:0.27-0.38μgkg-1),分别。
本研究于2021年10月6日在中国临床试验注册中心(注册编号:ChiCTR2100051827)注册。
Laryngeal mask airway(LMA) have been widely used in clinical practice. Irritation to the patient during the insertion of a laryngeal mask can cause hemodynamic fluctuations, which is particularly unsafe for geriatric patients. We used probit regression analysis to determine the median effective dose of sufentanil to inhibit the response to LMA insertion in geriatric patients.
A total of 90 patients were selected for the
study using the following inclusion criteria: age ≥ 65 years old, ASA grade I-III, and scheduled to undergo intravenous general anesthesia with LMA insertion. Each patient received a dose of sufentanil for anesthesia induction in one of six levels: 0.05, 0.1, 0.15, 0.2, 0.25, or 0.3 μg kg-1. LMA insertion was scored with a 3-point, 6-category scale, with scores ≥ 16 indicating effective LMA insertion, and < 16 indicating ineffective LMA insertion. Mean arterial blood pressure (MAP), heart rate (HR), and bispectral index (BIS) were recorded 1 min before induction (T1), 1 min after induction (T2), 1 min after LMA insertion (T3), and 5 min after LMA insertion (T4) in each group. In addition, the plasma norepinephrine (NE) levels and adverse reactions were measured at T2 and T3 in each dosage group.
Probit regression analysis showed that the ED50 of sufentanil inhibiting the response to LMA insertion in geriatric patients was 0.18 μg kg-1 (95% CI: 0.16-0.21 μg kg-1), and the ED95 was 0.31 μg kg-1 (95% CI: 0.27-0.38 μg kg-1), and the probit(p) = -2.34 + 12.90 × ln(Dose)([Formula: see text] = 0.725, p = 0.948). Among all the patients, the number of effective LMA insertions was 57 (group A), and the number of ineffective LMA insertions was 33 (group B). The MAP, HR, and NE in group B were significantly higher than in group A at T3.
Sufentanil can effectively inhibit the patient\'s response to LMA insertion, with stable hemodynamics and small stress response. The ED50 and ED95 were 0.18 μg kg-1 (95% CI: 0.16-0.21 μg kg-1) and 0.31 μg kg-1(95% CI: 0.27-0.38 μg kg-1), respectively.
This
study was registered in the Chinese Clinical
Trial Registry (Registration number: ChiCTR2100051827 ) on October 6, 2021.