新辅助化疗乳腺癌患者靶控输注依托咪酯意识消失时效应室靶浓度的EC50

摘要

Objective To determine the Effcet-site EC50 of etomidate to cause loss of consciousness in patients who accepted adjuvant chemotherapy. Methods According to the therapeutic method before their operation,ninety breast cancer patients undergoing elective operations were allocated to 3 groups:non-adjuvant chemotherapy group (group Ⅰ ,n=30),Taxol group (group Ⅱ ,n=30),Adriamycine+Cyclophosphamide+5-Fu group (group Ⅲ ,n=30). TCI etomidate was given by"up and down "method for 10 min in each group. The ration of two close effect-site concentrations was 1.25. Record the state of consciousness of each patient.Results The EC50 in non-adjuvant chemotherapy group was 0.58 mg/L,the 95% confidence level was 0.53 mg/L～0.63 mg/L. The EC50 in Taxol group was 0.34 mg/L,the 95% confidence level was 0.32 mg/L～0.37 mg/L. The EC50 in non-adjuvant chemotherapy group was0.35μg/ml,the 95% confidence level was0.32 mg/L～0.39 mg/L.Conclusion The EC50 of etomidate to cause loss of consciousness in adjuvant chemotherapy group is low than control group.%目的 测定新辅助化疗后患者靶控输注(target-controlled infusion,TCI)依托咪酯意识消失时的半数效应室靶浓度(EC50).方法 90例ASA Ⅰ或Ⅱ级,同时期行乳腺癌切除手术的乳腺癌患者,根据术前是否接受新辅助化疗以及化疗方案分为未化疗组(Ⅰ组),紫杉醇化疗4周期组(Ⅱ组),药物联合化疗4周期组(Ⅲ组).按序贯法给予依托咪酯靶控输注10 min,相邻效应室靶浓度之间比率为1.25.结果 未化疗组患者意识消失的半数效应室靶浓度(EC50)为0.58 mg/L,95%可信区间为0.53 mg/L～0.63 mg/L.紫杉醇化疗组患者意识消失的EC50为0.34 mg/L,95%可信区间为0.32 mg/L～0.37 mg/L.药物联合化疔组患者意识消失的EC50为0.35 mg/L,95%可信区间为0.32 mg/L～0.39 mg/L.结论 乳腺癌新辅助化疗后患者靶控输注依托咪酯时意识消失的EC50低于未化疗患者.