| Objective:To observe the effect of continuous target-controlled infusion of low concentration of remifentanil on blood pressure,heart rate,cough,agitation and extubation time in obese patients by sequential method,and to explore the optimal plasma target concentration that can inhibit extubation response in obese patients without affecting extubation time and to provide a reference for the anesthesia management of clinical obese patients.Methods:A total of 70 obese patients selected at random from May 2017 to December 2017 in the xinjiang uygur autonomous region people's hospital,at ASA grade?,?and with BMI 3035 kg/m2 were randomly divided into control group?n=20?and experimental group?n=50?undergoing elective anesthesia with laparoscopic cholecystectomy?LC?.The modified Dixon sequential method was used in the experimental group to study the relationship between the two groups.The difference of plasma concentration between adjacent remifentanil and TCI was 0.2ng/ml and 1.4ng/ml respectively.If the patient extubated positive,one patient received remifentanil TCI at a higher concentration,and remifentanil TCI at a lower concentration if the extubation reaction was negative.The median effective concentration(EC50)and 95%confidence interval?CI?of remifentanil in extubation were calculated by Probit Probability Regression Analysis.The extubation time of each concentration test group was recorded and compared with the control group.Results:The EC500 of plasma remifentanil for TCI to inhibit extubation reaction was 1.58?g/L?95%CI was 1.401.81?g/L?in obese patients under general anesthesia.The extubation time in patients received 1.40-1.81?g/L remifentanil for TCI?8.5±0.4?min did not differ from that in control group?8.3±0.6?min?P>0.05?.Conclusion:Remifentanil at concentration of 1.58?g/L for TCI inhibited extubation reaction but without affecting the extubation time in obese patients under general anesthesia. |
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