无痛胃镜检查时布托啡诺抑制吞咽反射ED50和ED95的测定

ED50 and ED95 of butorphanol required to avoid swallow reflex in painless gastroscopy

摘要:

目的 测定不同剂量丙泊酚复合布托啡诺无痛胃镜检查时，布托啡诺抑制吞咽反射的ED50和ED95值。方法 将76例无痛胃镜检查患者随机分为P1组和P2组，P1组给予丙泊酚2.0 mg/kg复合布托啡诺静脉麻醉，P2组给予2.5 mg/kg丙泊酚复合布托啡诺静脉麻醉。布托啡诺初始剂量为5.0 μg/kg，根据吞咽反射抑制情况，运用Dixon序贯法确定下一例患者使用剂量，应用Probit分析得出两组患者布托啡诺抑制吞咽反射ED50和ED95值。结果 P2组低血压发生率明显高于P1组（P < 0.05）；P1组和P2组布托啡诺抑制吞咽反射的ED50分别为3.5 μg/kg（95%CI：2.9～4.1）和3.1 μg/kg（95%CI：2.4～3.5）；P1组和P2组抑制吞咽反射的ED95分别为5.8 μg/kg（95%CI：4.7～15.9）和5.0 μg/kg（95%CI：4.1～12.3）。结论 布托啡诺复合丙泊酚2.0和2.5 mg/kg无痛胃镜检查时，抑制吞咽反射的ED50分别为3.5和3.1 μg/kg，ED95分别为5.8和5.0 μg/kg，对临床无痛胃镜麻醉用药具有指导意义。

Abstract:

Objective To determine ED50 and ED95 of butorphanol required to avoid swallow reflex combined with different dose propofol in painless gastroscopy.Methods 76 paients underwent painless gastroscopy were randomly divided into groups P1 and group P2. Group P1 was given propofol 2.0 mg/kg combined with butorphanol and group P2 with 2.5 mg/kg combined with butorphanol. The dose of butorphanol for each subsequent patient was determined by the inhibition of swallow reflex in the previous patient with the Dixon up-and-down method. Butorphanol started at a dose of 5.0 μg/kg on the first patient. The ED50 and ED95 were calculated using Probit regression.Results Incidence of hypotension in group P1 was significantly lower than that in group P2 (P < 0.05). The ED50 in group P1 was 3.5 μg/kg (95%CI: 2.9 ~ 4.1) and in group P2 was 3.1 μg/kg (95%CI: 2.4 ~ 3.5) respectively. The ED95 in group P1 was 5.8 μg/kg (95%CI: 4.7 ~ 15.9) and in group P2 was 5.0 μg/kg (95%CI: 4.1 ~ 12.3).Conclusion Combined with propofol 2.0, 2.5 mg/kg, ED50 of butorphanol required to avoid swallow reflex were 3.5 μg/kg and 3.1 μg/kg respectively and ED95 were 5.8 μg/kg and 5.0 μg/kg respectively in painless gastroscopy. The results are instructive for painless gastroscopy anesthesia.