| 谢杨莉,王波,余建明.性别因素对复合依托咪酯时阿芬太尼抑制老年患者喉罩置入反应有效剂量的影响[J].浙江中西医结合杂志,2026,36(5): |
| 性别因素对复合依托咪酯时阿芬太尼抑制老年患者喉罩置入反应有效剂量的影响 |
| The influence of gender factors on the effective dose of alfentanil in suppressing laryngeal mask airway insertion response in elderly patients when combined with etomidate |
| 投稿时间：2025-12-23 修订日期：2026-03-03 |
| DOI： |
| 中文关键词: 性别因素 老年患者 阿芬太尼 剂量效应关系 喉罩 |
| 英文关键词:Sex factors Elderly patients Alfentanil Dose-response relationship Laryngeal mask airway |
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| 中文摘要: |
| 目的 评价性别因素对复合依托咪酯时阿芬太尼抑制老年患者喉罩置入反应有效剂量的影响。方法 选择择期行喉罩下全身麻醉的老年患者，年龄≥65岁，ASA为I或II级，分为男性组、女性组。采用改良Dixon序贯法进行试验，两组患者的依托咪酯剂量均为0.2mg/kg，首例阿芬太尼剂量均为10μg/kg，下一例患者的阿芬太尼剂量取决于上一例患者喉罩置入反应是否为阳性，若为阳性，下一例患者剂量增加1μg/kg，若为阴性，下一例患者剂量减少1μg/kg，重复此种操作直至出现7个阳性阴性反应交叉点后停止研究。喉罩置入反应阳性：喉罩置入后2min内患者的最高心率或平均动脉压升高幅度超过该患者基础值的20%。使用probit法计算复合依托咪酯时阿芬太尼抑制老年患者喉罩置入反应的半数有效剂量（ED50）及95%可信区间（95%CI）。结果 男性组共纳入23例患者，女性组共纳入26例患者。男性组的ED50及95%CI为6.672（6.045～7.273）μg/kg，女性组的ED50及95%CI为6.095（5.416～6.648）μg/kg，两组患者的ED50比较差异有统计学意义（P＜0.05）。结论 复合依托咪酯时，阿芬太尼抑制老年女性患者喉罩置入反应的ED50较男性更小，麻醉效力更强。 |
| 英文摘要: |
| Objective: To evaluate the effect of gender on the effective dose of alfentanil in suppressing laryngeal mask airway (LMA) insertion response in elderly patients when combined with etomidate. Methods: Elderly patients scheduled for general anesthesia with LMA, aged ≥ 65 years, with ASA grade I or II, were divided into male and female groups. A modified Dixon sequential method was used for the trial. The etomidate dose for both groups was 0.2 mg/kg, and the initial alfentanil dose was 10 μg/kg. The alfentanil dose for the next patient was adjusted based on the response of the previous patient to LMA insertion. If the response was positive, the dose for the next patient was increased by 1 μg/kg; if negative, it was decreased by 1 μg/kg. The study was stopped after 7 positive-negative response crossover points were reached. A positive LMA insertion response was defined as an increase in the highest heart rate or mean arterial pressure within 2 minutes after LMA insertion exceeding 20% of the patient's baseline value. The ED50 and 95% confidence interval (CI) of alfentanil in suppressing LMA insertion response when combined with etomidate in elderly patients were calculated using the probit method. Results: A total of 23 patients were included in the male group and 26 in the female group. The ED50 and 95% CI of the male group were 6.672 (6.045 - 7.273) μg/kg, and those of the female group were 6.095 (5.416 - 6.648) μg/kg. There was a statistically significant difference in ED50 between the two groups (P < 0.05). Conclusion: When combined with etomidate, the ED50 of alfentanil in suppressing LMA insertion response in elderly female patients is smaller than that in male patients, indicating a stronger anesthetic effect. |
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