The EC₅₀ Of Pediatric Intubation Without Muscle Relaxant With TCI Propofol Compounding Dexmedetomidine

Objective: To determine the median effective propofol target plasmaconcentration (EC₅₀) in pediatric when target-controlled infusion of propofolcombined with dexmedetomidine without the muscle relaxants downstreamintubationMethods:21children were selected in September2012to November2012at the First Hospital of Jilin University undergoing adenoidectomytonsillectomy surgery. ASA physical status I level, age3-7years, weighing10-30kg, height95-120cm. Generally in good condition before surgery. Allchildren with preoperative routine forbidden to drink, fasting. And the patientssuffering from congenital heart disease, liver and kidney dysfunction,respiratory disease, a history of children with protein allergy history, knownproteins or dexmedetomidine allergy in children were excluded.Children into the operating room open venous access, connect the monitor,regular monitoring of blood pressure （SBP/DBP）, heart rate （HR）,electrocardiogram （ECG）, pulse oximetry degrees （SpO2）. All the patients wereusing the pump （A） SlgoTCI-Ⅲ type target-controlled infusion of propofol（Diprivan, AstraZeneca, Italy, batch H20100646） start before induction ofchildren with age, sex, weight, height and other parameters prepared better.First intravenous infusion right medetomidine （Jiangsu Hengrui Medicine Co.Ltd. batch number11091934） the loading dose0.6μg/kg, administration timefor10min, target-controlled infusion of propofol after the initial target plasmaconcentration set as5.0μg/ml. Let it completed by the same seniority of theanesthetist plasma and effect-site concentration reaches equilibriumendotracheal intubation and mechanical ventilation, connected to the anesthesiamachine. Set tidal volume of8to10ml/kg, respiratory rate13to18times/min,breathing ratio of1:2, oxygen flow2L/min. Propofol target plasma concentration measured by Dixon sequential andunder one cases of children with tracheal intubation conditions are satisfied ornot a corresponding increase or decrease0.2μg/mL. On the case of childrenwith tracheal intubation conditions for clinical satisfied, the next example toreduce a target concentration gradient for clinical previous children intubatingconditions are not satisfied, the next example a target concentration gradient.Research to the the intubation success/failure sixth crossing point to the end ofthe experiment.Record children burglary （T0）, dexmedetomidine infusion10min （T1）,intubation （T2）,1min （T3） after intubation points BP, MAP, HR, SpO2. Recordintubation laryngoscope placement difficulty （mandibular laxity）, glottislocation and activity of airway responsiveness （cough）, physical activity. Theintubation conditions Reference Viby-Mogen sen: excellent: laryngoscopeplaced easily sound outside the exhibition and no activity, no cough, nophysical activity. Good: laryngoscope placement moderate, glottis centeractivities, slight cough, slight physical activity. Difference: laryngoscopeplacement difficulties, glottis closed, persistent cough, strong physical activity.Intubating conditions as excellent and good clinical satisfaction, the differenceis clinically not satisfied. Deepened when intubating conditions are not satisfiedwith the clinical anesthesia to give cis-atracurium0.15mg/kg after intubation.Application SPSS19.0software for statistical analysis, the measurementdata are presented as mean±standard deviation （x±s） said. Dixon sequentialmethod formula calculated the compound dextromethorphan prop-ethyl timingto achieve a satisfactory clinical pediatric intubation conditions of musclerelaxants propofol EC₅₀and its95%confidence interval.Results: Composite dexmedetomidine timing, propofol is used to pediatricintubation inorganic loose EC₅₀4.81μɡ/ml,95%confidence interval of（4.66,4.95） μɡ/ml. Conclusion: The composite dexmedetomidine given0.6μg/kg to achievea satisfactory clinical pediatric intubation conditions of muscle relaxants phenolhalf target plasma concentration of propofol4.81μg/ml.