国际麻醉学与复苏杂志   2018, Issue (2): 7-7
    
舒芬太尼抑制高强度聚焦超声治疗子宫腺肌病和子宫肌瘤疼痛的半数有效量及95%有效量
李伟1()
1.上海市第一妇婴保健院
The 50% effective dose and 95% effective dose of sufentanil for high intensity focused ultrasound treatment of uterine adenomyosis and myoma
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摘要:

目的 观察咪达唑仑辅助下舒芬太尼抑制高强度聚焦超声(high intensity focused ultrasound, HIFU)治疗子宫腺肌病和子宫肌瘤疼痛的量效关系。 方法 分别选取32例子宫腺肌病和30例子宫肌瘤患者,ASA分级Ⅰ、Ⅱ级,入室后给予咪达唑仑30 μg/kg镇静,手术开始前5 min注射舒芬太尼,治疗开始后观察20 min评估患者的疼痛评分。按照序贯法进行试验,初始舒芬太尼剂量为0.10 μg/kg,按等比级数r=1.4计算出5个剂量,根据前一例患者的镇痛满意程度,下一例患者增加或减少一个阶梯剂量。采用概率单位回归方法计算舒芬太尼的ED50和95%有效量(95% effective dose, ED95)及其95%CI。 结果 舒芬太尼抑制HIFU治疗子宫腺肌病疼痛的ED50(95%CI)为0.18(0.08~0.26) μg/kg,ED95(95%CI)为0.35(0.26~1.30) μg/kg; 抑制HIFU治疗子宫肌瘤疼痛的ED50(95%CI)为0.13(0.04~0.20) μg/kg,ED95(95%CI)为0.34(0.22~1.20) μg/kg。 结论 复合咪达唑仑时,舒芬太尼抑制HIFU治疗子宫腺肌病和子宫肌瘤的ED50及ED95各不相同。

关键词: 高强度聚焦超声; 咪达唑仑; 舒芬太尼; 子宫腺肌病; 子宫肌瘤; 量效关系
Abstract:

Objective To determine the dose-response relationship of sufentanil combined with midazolam for high intensity focused ultrasoun(HIFU) treatment of uterine adenomyosis and myoma. Methods Thirty two patients have uterine adenomyosis and 30 patients have uterine myoma, ASA classⅠ,Ⅱ, were enrolled. The patients were injected 30 μg/kg midazolam for sedation. Sufentanil was injected intravenously 5 min before the onset of operation. In addition, the sequential method was used in this study. The first dose of sufentanil was 0.10 μg/kg, set geometric series r=1.4 to calculate five step doses, the doses of sufentanil in the next patient was increased or decreased by a step dose according to the analgesia effect of the previous patient. Probit analysis was applied to calculated the ED50(95%CI) and 95% effective dose(ED95)(95%CI) of sufentanil. Results The ED50(95%CI) of sufentanil for uterine adenomyosis is 0.18(0.08-0.26) μg/kg. ED95 (95%CI) of sufentanil for uterine adenomyosis is 0.35(0.26-1.30)μg/kg. The ED50(95%CI) of sufentanil for uterine myoma is 0.13(0.04-0.20) μg/kg. The ED95(95%CI) of sufentanil for uterine myoma is 0.34(0.22-1.20) μg/kg. Conclusions Combined with midazolam 30 μg/kg, sufentanil has different ED50 and ED95 for uterine adenomyosis and myoma.

Key words: High intensity focused ultrasound; Midazolam; Sufentanil; Adenomyosis; Myoma; Dose-response relationship