二异丙酚靶控输注血药浓度与听觉诱发电位指数的相关性  

Relationship of auditory evoked potential (AAI) index and plasma concentration during propofol administered by target-controlled infusion (TCI)

作　　者：邓丽云[1] 郭晋铎[1] 贺萍[2] 赵丽[3] 赵嘉训[1] 

机构地区：[1]山西省肿瘤医院麻醉科,太原030013 [2]山西医科大学研究生处 [3]山西省肿瘤研究所药理室

出　　处：《肿瘤研究与临床》2008年第3期179-181,共3页Cancer Research and Clinic

摘　　要：目的 探讨二异丙酚靶控输注(TCI)血药浓度与听觉诱发电位指数(AAI)的相关性.方法 选择ASA Ⅰ～Ⅱ级腹部择期手术的肿瘤患者10例.桡动脉置管以采集血样.二异丙酚TCI系统使用法国Base Primea公司Orchestra输注泵,内嵌Schnider药代学参数,靶质量浓度在麻醉诱导设定为3mg/L,气管插管后调为1.7～2.5mg/L,复合吸入0.5MAC的异氟醚.术中无创麻醉深度监测仪监测听觉深度AAI值.分别于二异丙酚诱导即刻(T0)、诱导后1、3、5、10、15、30、60、90min(T1-8)、停止输注后10、20 min(T9-10)采桡动脉血5 ml,用荧光光度仪检测二异丙酚的血药浓度.结果 实测质量浓度显著低于靶质量浓度(P＜0.05),实测质量浓度与靶质量浓度间呈不平行关系,实测质量浓度随时间的延长有下降的趋势.AAI值与实测质量浓度呈显著负相关(r=-0.818,P＜0.01).结论 应用Schnider参数进行二异丙酚TCI实测质量浓度与靶质量浓度间呈不平行关系,实测质量浓度随时间的延长有下降的趋势;AAI值与二异丙酚血药质量浓度之间呈显著负相关,可间接反映二异丙酚血药质量浓度.Objective To assess the relationship between auditory evoked potential (AAI) index and plasma concentration of propofol administered by target-controlled infusion (TCI) in Chinese.Methods Ten ASA Ⅰ～Ⅱ tumor patients (5 males,5 females) scheduled for elective abdominal surgery under general anesthesia was enrolled in this study.Age ranged from 34 to 61 years,body weight from 52 to 79 kg and height from 155 to 178 cm.Radial artery was cannulated for blood sampling.The patients were premeditated with intravenous injection Midazolam 0.06 mg/L.Anesthesia was induced by fentanyl 2μg/kg,vecuronium 0.1 mg/kg and TCI of propofol which the target plasm concentration was set at 3 mg/L.After intubation,the target plasma concentration of propofol was adjusted at 1.7～2.5 mg/L.Vecuronium was continuous infusions at 2～3mg/h.Anesthesia was maintained with fentanyl-TCI of propofol-vecuronium and inhalation of 0.5 MAC isoflurane.The TCI system was composed of Base Primea company orchestra infusion pump using,the schnider pharmacokinetics model.ECG,Bp,HR,PETCO2,SpO2 and TETISO were monitored during anesthesia.Danmeter company A-line depth of anesthesia monitor recorded AAI index.Blood samples were taken at induction of anesthesia (To baseline),1,3,5,10,15,30,60 min (T1-7) and after cessation of infusion 10 and 20 min (T9-10).Plasma propofol concentration were determinated by fluorescence photometry.Results Compared with target concentrations,the measured concentrations of propofol were significantly lower during TCI(P＜0.05).There was negative correlation between AAI and plasma propofol concentrations(r=-0.818,P＜0.01).Conclusion On base of the Schnider pharmacokinetics model,the target propofol concentrations are not paralleled to plasma propofol concentrations which is descending with time prolongation.From negative correlation between AAI index and plasma propofol concentrations,AAI index will reflect indirectly plasma propofol concentrations.

关 键 词：二异丙酚 诱发电位 听觉 

分 类 号：R614[医药卫生—麻醉学]