腰椎手术静-吸复合麻醉脑电双频指数为50时的丙泊酚半数有效血浆靶浓度

摘要

目的：观察腰椎手术静-吸复合麻醉脑电双频指数(BIS)维持50时丙泊酚半数有效血浆靶浓度(Cp50)。方法择期行腰椎间盘髓核摘除术患者,年龄40~56岁,术中麻醉维持采用吸入0.5 MAC 七氟醚、静脉泵注瑞芬太尼0.2μg·kg-1·min-1和维库溴铵0.08 mg·kg-1·h-1,同时TCI 丙泊酚。采用序贯法确定丙泊酚靶浓度,初始血浆靶浓度为1.8μg/ml,相邻浓度比为1∶1.1；若患者术中平均 BIS 值>50,则下一例患者靶浓度为1.98μg/ml；若 BIS≤50,则下一例患者靶浓度为1.64μg/ml,以此类推。计算丙泊酚 Cp50及其95%可信区间(CI)。结果共有26例患者完成序贯试验。丙泊酚 Cp50为1.61μg/ml(95%CI 1.52~1.70)μg/ml。结论腰椎手术中0.5 MAC 七氟醚复合瑞芬太尼及 TCI 丙泊酚麻醉,术中维持 BIS 值为50时所需丙泊酚的 Cp50为1.61μg/ml。%Objective To investigate the median effective plasma target concentration of propo-fol (Cp50 )needed for lumbar surgery during inhalation-intravenous balanced anesthesia when BIS is 50.Methods Patients aged 40-56 years,scheduled for vertebral pulp ectomy were included.Anesthe-sia were maintained by TCI of propofol,sevoflurane 0.5 MAC,remifentanyl 0.2 μg·kg-1 ·min-1 , and vecuronium 0.08 mg·kg-1 ·h-1 .The target plasma concentration of propofol was initially set at 1.8 μg/ml,and adjusted by the sequential up-and-down methods,based on BIS index.The Cp50 of propofol and its 95% confidence interval (CI)were calculated.Results Twenty-six patients were en-rolled in this study.The median effective plasma target concentration of propofol was 1.61 μg/ml (95%CI 1.52-1.70)μg/ml.Conclusion The Cp50 of propofol needed for maintaining the BIS index of 50 is 1.61 μg/ml during the anesthesia with 0.5 MAC of sevoflurane combined with remifentanyl in lumbar surgery.