瑞芬太尼抑制老年病人经皮椎体后凸成形术中疼痛反应的半数有效浓度及95%有效浓度

doi:10.3969/j.issn.1003-9198.2022.12.016

Abstract

Abstract: Objective To explore the median effective concentration (EC₅₀) and 95% effective concentration (EC₉₅) of remifentanil inhibiting balloon dilation-induced pain response in the elderly patients undergoing percutaneous kyphoplasty (PKP). Methods The patients scheduled for selective PKP under monitored anesthesia care (MAC) were sequentially enrolled in this trial. Target-controlled infusion (TCI) of remifentanil was performed from 5 min before surgery to time-point of bone cement implantation. The plasma concentration of remifentanil was set at 1.44 ng/mL in the first patient, and the ratio of adjacent target concentrations was 1.2. When the patients were treated with balloon dilatation,the score of Numerical Rating Scale(NRS)>3 was regarded as positive reaction. When a positive reaction occurred, the next patient will be treated with an increased concentration gradient. And if a negative reaction occurred, the next patient will be treated with a decreased concentration gradient. The trial was finished until 6 intersections from positive reaction to negative one. EC₅₀ and EC₉₅ of remifentanil effectively inhibiting pain response induced by vertebral balloon dilatation in the elderly patients were calculated by Probit regression analysis method. Results A total of 20 patients were enrolled, with ASA grade Ⅰ-Ⅲ. TCI of remifentanil significantly decreased the intraoperative NRS in the elderly patients scheduled for PKP. By Probit regression analysis method, EC₅₀ and EC₉₅of remifentanil inhibiting the pain response induced by balloon dilation in the elderly patients undergoing percutaneous kyphoplasty was 0.950 ng/mL (95%CI: 0.768-1.103 ng/mL) and 1.179 ng/mL (95%CI: 1.049-4.595 ng/mL), respectively. Conclusions TCI of remifentanil can effectively inhibit the pain response induced by balloon dilation in the elderly patients undergoing PKP. EC₅₀ and EC₉₅ of remifentanil is 0.950 ng/mL and 1.179 ng/mL, respectively.

Key words: remifentanil, percutaneous kyphoplasty, target controlled infusion, median effective concentration, 95% effective concentration

CLC Number:

R614

RUAN Shan, CHEN Xia, YANG Wen, ZHANG Peng, GUI Bo, QU Lei-qiu. Median effective concentration and 95% effective concentration of remifentanil inhibiting pain response in elderly patients undergoing percutaneous kyphoplasty[J]. Practical Geriatrics, 2022, 36(12): 1251-1254.

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Median effective concentration and 95% effective concentration of remifentanil inhibiting pain response in elderly patients undergoing percutaneous kyphoplasty

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