异丙酚效应室靶控输注与血浆靶控输注的比较.pdfVIP

654 中华麻醉学杂志 2003年 9月第 23卷第 9期 Chin J Anesthesiol，September 2003，Vol 23，No．9 ·临 床 研 究 · 异丙酚效应室靶控输注与血浆靶控输注的比较 王庚 吴新 民 曲元 宋琳琳 【摘要】 目的 观察人工流产手术使用效应室靶控输注异丙酚时的药效学变化，并与血浆靶控 输注比较。方法 50例患者随机分成效应室靶控(E)和血浆靶控(B)两组 ，给予芬太尼 1 g·kg 后分 别以4 g·ml (E组)和 6 g·ml (B组)的靶浓度输注异丙酚，观察起效时间、恢复时间、脑电频谱 (BIS)值以及心率(HR)、血压(BP)、脉搏氧饱和度(sp02)。结果 E组起效时间及恢复时间均显著短 于 B组(P0．01)，而 BIS值差异无显菩性(P0．05)，同时 E组的 SpO!显著低于 B组(P0．05)。结 论 效应室靶控和血浆靶控同样适用于人工流产手术，并且起效快 、恢复快，但同时应注意其呼吸抑 制作用 。 【关键词】 药物投与系统；二异丙酚；脑电描记术 ；流产 ，人工 Anesthesia witlI propofol by target—controlled infusion targeting efect-site vs plasma WANG Geng． U Xin-min，Qu Yuan，et a1．Department ofAnesthesiology，First Hospital，Peking University，Beijing 100034， China 【Abstract】 Objective To evaluate the difference between the pharmacodynamic profile of propofol administered by target—controled infusion(TCI)targeting efect site and plasma ．Methods Fi ASA I一Ⅱ patients aged 16—45 yr，undergoing artificial abortion were randomly divided into two groups ：group E targeting efect·site(n=25)and group B targeting plasma(n=25)．Propofol was infused during operation by TCI after a bolus of fentanyl 1 Itg’kg～ ．In group E the target efect—site concentration of propo fol was set at 4 g‘ml～ ， whereas in group B the target plasma propofol concentration was set at 6 g ml～ ．The following were recorded ： (1)the onset time：from start of propofol infusion to loss of eyelash reflex(T1)，to no response to verbal command (T2)and to pat on the shoulder(T3)；(2)the recovery time：from discontinuation of propofol infusion to eye opening(L )and to stating date of birth OI1 request(Ts)；(3)the calculated plasma and efect—site propofol concentration and BIS value at the five inten als；(4)duration of anesthesia；(5)the total amount of propofol consumed and(6)HR，BP and SpO!before，during and after anesthesia．Results Both onset time and recovery time were signifcantly shorter in group E than in group B，(P0．05 or 0．01)but there was no signifcant difference in BIS values between the two groups．