Determination of the median effective concentration (EC50) of propofol during oesophagogastroduodenoscopy in children
Determination of the median effective concentration (EC50) of propofol during oesophagogastroduodenoscopy in children
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DOI：
10.1046/j.1460-9592.2001.00731.x
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发表时间：
2001-09-01
期刊：
影响因子：
--
通讯作者：
Drover, DR
中科院分区：
文献类型：
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作者：
Hammer, GB;Litalien, C;Drover, DR
背景：丙泊酚常用于儿童食管胃镜检查（OGD）的麻醉。尽管如此，在这种setting.Methods中使用的丙泊酚的血浆浓度-反应关系尚未建立：为了确定丙泊酚的EC 50 OGD期间，我们研究了12名儿童年龄在3-10岁。未给予术前用药。基于儿科药代动力学模型，使用STANELS软件通过靶控输注系统给予丙泊酚。使用狄克逊描述的“上下”法测定EC 50。因此，从第二名受试者开始，每名患者的靶血浆丙泊酚浓度由前一名患者的反应确定。如果患者在手术过程中有最小的运动并且心率（HR）和血压（BP）保持小于或等于基线的120%，则认为患者是“应答者”。过度运动的患者，即需要超过温和的约束，或表现出HR和BP >基线的120%的患者，被认为是“nonresponders”. Results：The EC 50 of propofol during OGD was 3.55 mug.ml（-1）in this study.Conclusions：在50%的未预先用药的儿童中，与OGD充分麻醉相关的血浆丙泊酚浓度为3.55 mug-ml（-1）。该浓度高于成人患者中OGD所需的浓度。
Background: Propofol is commonly used to provide anaesthesia for children undergoing oesophagogastroduodenoscopy (OGD). Despite this, the plasma concentration-response relationships for propofol used in this setting have not been established.Methods: In order to determine the EC50 of propofol during OGD, we studied 12 children aged 3-10 years. No premedication was given. Propofol was administered via a target-controlled infusion system using the STANPUMP software based on a paediatric pharmacokinetic model. The 'up-and-down' method described by Dixon was used to determine the EC50. Accordingly, the target plasma propofol concentration for each patient, beginning with the second subject, was determined by the response of the previous patient. A patient was considered a 'responder' if there was minimal movement and the heart rate (HR) and blood pressure (BP) remained less than or equal to 120% of baseline during the procedure. Patients who moved excessively, i.e. requiring more than gentle restraint, or who manifest HR and BP >120% of baseline, were considered 'nonresponders'.Results: The EC50 of propofol during OGD was 3.55 mug.ml(-1) in this study.Conclusions: The plasma propofol concentration associated with adequate anaesthesia for OGD in 50% of unpremedicated children is 3.55 mug-ml(-1). This concentration is higher than that required for OGD in adult patients.