摘要
目的 评估内嵌Marsh等报道的药代学参数的TCI系统的准确性。方法22例ASAⅠ～Ⅱ级择期手术患者,<65岁(Y组)和>65岁(E组)各11例,异丙酚靶浓度从2μg/ml开始以1μg/ml递增直至意识消失,分析血浆浓度。计算每个样本的百分比预测误差(％PE)、稳定误差(％CE)和组间个体内中位数预测误差(MDPE)、中位数绝对误差(MDAPE)、中位数稳定误差(MDCE)、中位数绝对稳定误差(MDACE)。结果 升高靶浓度时系统产生明显的超射。E组异丙酚血浆浓度的PE和绝对值PE分别是63.3％和66.2％,Y组则分别是62.1％和62.7％。E组CE和绝对值CE分别是-0.3％和12.7％,Y组则分别是0.6％和13.5％,组间无差异(P>0.05)。E组和Y组中位数MDPE(=中位数MDAPE)分别为78.1％和66.1％,MDCE分别是-0.2％和0.8％,MDACE分别是12.5％和13.5％。实测浓度和预测浓度呈显著直线相关(P<0.01)。结论Marsh参数用于国人靶控输注,实测浓度和预测浓度的差异性较大,但系统能够维持稳定的血浆浓度。
Objective To evaluate the accuracy of target-controlled infusion (TCI) of propofol using pharmacokinetic parameters reported by Marsh to predict plasma propofol concentration in Chinese. MethodsTwenty-two ASA I - II patients were divided into two groups: group Y aged< 65 yr (n = 11) and group E ages >65 yr ( n = 11). Patients with liver, kidney or cardiovascular diseases were excluded. The patients were premedicated with pethidine 50mg and phenobarhital 0.1 g im. Radial artery and internal jugular vein(IJV) were cannulated. The pharmacokinetic parameters incorporated in the Graseby 3500 pump we used were: V1=228 ml-kg-1 , K10 =0.119 min-1 ,K12=0.112 min-1, K2l=0.055min-1 , K13 =0.0419 min-1 ,K31 =0.0033 min-1. Target concentration was started with 2ug-ml-1 and increased at increment of 1ugml-1 until loss of consciousness. The patient was then intubated. When target concentration of propofol was increased, the concentration of inhalation anesthetic was reduced to maintain hemodynamic stability. When target concentration of propofol was increased, arterial blood sample was taken 1-3 times for determination of plasma propofol concentration measured by HPLC (Agilent 1100) . Then blood samples every 10-15 min. For each sample prediction error(PE) and constancy error(CE) were calculated. For each patient median prediction error(MDPE), median absolute prediction error(MDAPE) . Median absolute constancy error (MDACE) and median constancy error (MDCE) were calculated.ResultsThere was remarkable initial overshot. PE and absolute PE were 63.3 % and 66.2 % in group E and 62.1 % and 62.7% in group Y. CE and absolute CE were -0.3% and 12.7% in group E and 0.6% and 13.5% in group Y. The median value of MDPE ( = the median value of MDAPE) was 78.1 % in group E and 66.1% in group Y. The median value of MDCE was 0.2% (group E) and 0.8% (group Y) and MDACE was 12.5% (group E) and 13.5% (group Y) . The measured concentrations were significantly linearly correlated with the premedicated concentrations. Conclusion TCI system with propofolpharmacokinetic parameters reported by Marsh can lead to initial overshot and underestimate the measured plasma propofol concentration but it can maintain a stable plasma concentration
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2002年第11期660-663,共4页
Chinese Journal of Anesthesiology
关键词
药代动力学
二异丙酚
评价研究
靶控输注
Pharmacokinetic
Propofol
Evaluations studies
Target-controlled infusion
