| 摘要: |
| 目的：探讨经皮穴位电刺激对咪达唑仑致老年患者意识消失半数有效量（ED50）的影响。方法：选择在我院择期椎管内麻醉行骨科下肢手术老年患者 52 例，随机将患者分为 2 组：经皮穴位电刺激组和对照组。实施椎管内麻醉，刺激组选择双侧合谷穴、内关穴给予经皮穴位电刺激 20 min 后静脉注射咪达唑仑。对照组患者在相应穴位贴电极片，并连接刺激器，不予电刺激。以 OAA/S 评分≤ 2 分判定为意识消失。采用序贯法确定咪达唑仑剂量，初始剂量为 40 μg/kg，相邻剂量比为 1∶1.1。当出现 7 次阴阳交叉时终止试验。采用序贯法公式法计算咪达唑仑致患者意识消失 ED50 及其 95% 置信区间。结果：刺激组咪达唑仑致患者意识消失 ED50 及其 95% 置信区间为 40.5 μg/kg（95% CI 为 28.1~58.2 μg/kg），对照组为 47.7 μg/kg（95% CI 为 33.1~68.9 μg/kg），两组比较差异有统计学意义（P<0.05）。结论：经皮穴位电刺激可降低咪达唑仑致老年患者意识消失的 ED50。 |
| 关键词: 经皮穴位电刺激 咪达唑仑 老年 剂量效应关系 药物 |
| DOI：10.3969/j.issn.1007-6948.2019.06.006 |
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| 基金项目:天津市卫生和计划生育委员会中医中西医结合科研课题 （2017074） |
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| Effect of Transcutaneous Acupoint Electrical Stimulation on Half Effective Dose of Midazolam-induced Consciousness Loss in Elderly Patients |
| GUO Yan-hui,ZHAO Chong-fa |
| Department of Anesthesiology, Tianjin Haihe Hospital, Tianjin(300350), China |
| Abstract: |
| Objective To investigate the effect of transcutaneous acupoint electrical stimulation (TEAS) on half effective dose (ED50) of consciousness loss in elderly patients induced by midazolam. Methods Elderly patients undergoing lower limb surgery under elective spinal anesthesia in our hospital were randomly divided into two groups: TEAS group and control group, and given intraspinal anesthesia. In TEAS group, midazolam was injected intravenously after 20 min of TEAS at Hegu and Neiguan acupoints on both sides. The patients in the control group were given electrodes at corresponding acupoints and connected stimulator without electric stimulation. Awareness disappearance was judged by OAA/S score less than 2. The dose of midazolam was determined by sequential method. The initial dose was 40 μg/kg and the adjacent dose ratio was 1:1.1. The test was terminated when there were 7 crosses between yin and yang. Sequential formula method was used to calculate the ED50 and 95% confidence interval of consciousness loss induced by midazolam. Results The ED50 and 95% confidence interval of midazolam in stimulation group were 40.5 μg/kg (95% CI: 28.1–58.2 μg/kg) and 47.7 μg/kg (95% CI: 33.1–68.9 μg/kg) respectively. There were significant differences between the two groups (P<0.05). Conclusion TEAS can reduce ED50 in elderly patients with consciousness loss caused by midazolam. |
| Key words: Transcutaneous electrical acupoint stimulation midazolam old age dose effect relationship drugs |
