The median effective concentration (EC50) of propofol with different doses of fentanyl during colonoscopy in elderly patients.
The median effective concentration (EC50) of propofol with different doses of fentanyl during colonoscopy in elderly patients.
复制标题
老年患者结肠镜检查时异丙酚与不同剂量芬太尼的中位有效浓度（EC50）。
DOI：
10.1186/s12871-016-0189-y
复制
发表时间：
2016-04-21
影响因子：
2.2
通讯作者：
Lian J
中科院分区：
文献类型：
--
作者：
Li S;Yu F;Zhu H;Yang Y;Yang L;Lian J
丙泊酚和芬太尼是结肠镜检查中应用最为广泛的麻醉维持药物。在本研究中，我们测定了老年患者结肠镜检查所需丙泊酚的半数有效浓度（EC50），本研究的目的是阐述老年患者结肠镜检查联合使用芬太尼和丙泊酚时二者的药效学相互作用。
90名计划行结肠镜检查的老年患者按如下方式被随机、双盲分为三组：F0.5组（0.5 μg/kg芬太尼）、F1.0组（1.0 μg/kg芬太尼）和生理盐水对照组。通过靶控输注丙泊酚（Marsh模型，初始血浆浓度为2.0 μg/ml）和芬太尼实现麻醉。芬太尼注射3分钟后开始结肠镜检查。采用序贯增减法，以0.5 μg/ml的相邻浓度梯度测定不同剂量芬太尼下结肠镜检查时丙泊酚抑制患者有意识动作的EC50。同时记录麻醉相关不良事件及恢复特征。
老年患者结肠镜检查时丙泊酚的EC50在F0.5组为2.75 μg/ml（95%置信区间，2.50 - 3.02 μg/ml），F1.0组为2.05 μg/ml（95%置信区间，1.98 - 2.13 μg/ml），对照组为3.08 μg/ml（95%置信区间，2.78 - 3.42 μg/ml），组间比较差异有统计学意义（P < 0.05）。F1.0组患者的清醒时间和住院时长显著长于对照组（P < 0.05）。
芬太尼剂量增加至1.0 μg/kg可降低接受结肠镜检查老年患者所需的丙泊酚EC50，麻醉相关不良事件无显著差异，但清醒时间和出院时间延长。
中国临床试验注册中心 ChiCTR15006368。注册日期：2015年5月3日。
BackgroundPropofol and fentanyl are the most widely administered anesthesia maintaining drugs during colonoscopy. In this study, we determined the median effective concentration (EC50) of propofol required for colonoscopy in elderly patients, and the purpose of this study was to describe the pharmacodynamic interaction between fentanyl and propofol when used in combination for colonoscopy in elderly patients.MethodsNinety elderly patients scheduled for colonoscopy were allocated into three groups in a randomized, double-blinded manner as below, F0.5 group (0.5 μg.kg−1fentanyl), F1.0 group (1.0 μg.kg−1fentanyl) and saline control group. Anaesthesia was achieved by target-controlled infusion of propofol (Marsh model, with an initial plasma concentration of 2.0 μg.ml−1) and fentanyl. Colonoscopy was started 3 min after the injection of fentanyl. The EC50 of propofol for colonoscopy with different doses of fentanyl was measured by using an up-and-down sequential method with an adjacent concentration gradient at 0.5 μg.ml−1to inhibit purposeful movements. Anaesthesia associated adverse events and recovery characters were also recorded.ResultsThe EC50 of propofol for colonoscopy in elderly patients were 2.75 μg.ml−1(95 % CI, 2.50–3.02 μg.ml−1) in F0.5 group, 2.05 μg.ml−1(95 % CI, 1.98–2.13 μg.ml−1) in F1.0 group and 3.08 μg.ml−1(95 % CI, 2.78–3.42 μg.ml−1) in control group respectively (P< 0.05). Patients in the F1.0 group had a significantly longer awake time and length of hospital stay than those in control group (P< 0.05).ConclusionIncreasing doses of fentanyl up to 1.0 μg.kg−1reduces the propofol EC50 required for elderly patients undergoing colonoscopy, and there was no significant difference in anaesthesia associated adverse events but prolonged awake and discharge time.Trial registrationChinese Clinical Trial Registry ChiCTR15006368 . Date of registration: May 3, 2015.