摘要
目的 研究不同药代学参数的丙泊酚靶控输注（TCI）系统用于硬膜外麻醉时的药效学。方法 50例ASAⅠ～Ⅱ级的择期硬膜外麻醉手术患者，分别采用Marsh（M组）、Tackley（T组）、Shafer（S组）和Coetzee（C组）报道的丙泊酚药代学参数TCI镇静，靶浓度从0．4μg／mL开始，以0．4μg／mL的梯度逐渐上升，直至患者入睡。每个靶控浓度至少维持15min以上。记录各组镇静／警醒（OAA／S）评分、平均动脉压（MAP）和心率等。结果 M、T、S和C组丙泊酚50％意识消失浓度（EC50）分别为1．16、1．06、1．33和1．16μg／mL。MAP随靶控浓度的升高而降低，最大降低幅度在16％～21％；各组心率在TCI开始后均减慢。结论 硬膜外麻醉下TCI丙泊酚的镇静可控性强，血液动力学维持稳定。不同药代学参数的TCI系统在临床应用时各有特点。
Objective To determine the pharmacodynamics of target-controlled infusion （TCI） of propofol with different pharmacokinetic parameter sets during epidural anesthesia. Methods Fifty ASA grade Ⅰ-Ⅱ patients, received TCI of propofol with pharmacokinetic parameter sets reported by Marsh （M group） , Tackley （T group） , Shafer （ S group） and Coetzee （ C group） , beginning with 0.4 μg/mL, increasing in increments of 0.4μg/mL until the patients lost consciousness. TCI at each concentration maintained 15 min at least. The OAA/S,of propofol,mean arterial pressure （MAP） and HR were recorded at the end of the given target-controlled concentration. Results The ECso of propofol were 1.16, 1.06, 1.33 and 1.15μg/mL in M, T, S and C group, respectively. MAP decreased gradually along with the increase of target-controlled concentrations. The decreased range of MAP was between 16% and 21%. HR of each concentration was decreased gradually during TCI. Conclusion TCI of propofol can maintain stable blood pressure and adjust the depth of sedation accurately. TCI systems with different parameter sets have different pharmacodynamic characteristics.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2006年第1期84-86,共3页
Journal of Shanghai Jiao tong University:Medical Science
基金
杨浦区卫生系统学科带头人培养计划(2002AA002-009)资助项目
关键词
丙泊酚
硬膜外麻醉
靶控输注
镇静
propofol
epidural anesthesia
target-controlled infusion
sedation
