丙泊酚与异氟烷在平衡麻醉中的剂量-效应关系研究  

The dose-response relationship between propofol and isoflurane in balanced anaesthesia

作　　者：王尔民[1] 闫文英[2] 刘连海[1] 

机构地区：[1]德州市人民医院麻醉科,山东省德州253014 [2]德州市人民医院手术室,山东省德州253014

出　　处：《中国基层医药》2008年第10期1678-1679,1763,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的研究丙泊酚与异氟烷在平衡麻醉中的剂量．效应关系。方法择期平衡麻醉30例，以丙泊酚1．5mg／kg、维库溴铵0．12mg／kg、芬太尼2～4μg／kg诱导气管插管，以维库溴铵1．2μg·kg^-1·min^-1、芬太尼2μg·kg^-1·h^-1持续恒速泵入维持麻醉（直至手术结束前20min）。逐渐减小异氟烷浓度、增加丙泊酚剂量，使各平衡点的BIS值始终维持于50～60之间，记录各平衡点的异氟烷浓度／丙泊酚泵注剂量（并利用SPSS软件绘制散点图）、平均动脉压（MAP）（mmHg）、心率等。结果丙泊酚剂量、异氟烷浓度间的关系符合指数曲线模型，其曲线方程式为Y=102．991xexp（-1．4456x），判定系数R^2=0．784；丙泊酚最大剂量与异氟烷最大浓度间的比值为54／1。当仅依靠异氟烷吸入维持BIS值于50—60时，MAP较基础值下降明显（P〈0．05），随着异氟烷吸入浓度的下降、丙泊酚泵注剂量的增加，各平衡点的MAP、心率渐呈上升趋势，但与麻醉前相比，差异无统计学意义（P〉0．05）。结论当BIS维持于50～60时，丙泊酚剂量与异氟烷浓度之间符合指数曲线模型，合理应用丙泊酚可有效降低异氟烷的循环抑制作用。Objective To study the dose-response relationship between propofol and isoflurane in balanced anaesthesia. Methods 30 patients, age ranged from 46 to 68 years and body weight from 48 to 72 kilograms, were selected. Anaesthesia was induced with propofol 1.5mg/kg, vecuronium 0.12 mg/kg, fentanyl 2 - 4μg/kg, and maintained with vecuronium 1.2μg/kg,fentanyl 2μg/kg. lsoflurane was inhaled at first so that BIS could be maintained on the level of 50 - 60. Then, minishing the isoflurane concentration by 0.3% - 0.5% and adding the dosage of propofol synchronously, establishing 4 - 6 balanced level spots of anaesthesia, which could maintain BIS on the level of 50 - 60 all the time. Recording the isoflurane concentration,the dosage of propofol, MAP, HR, etc, and making the scatterplot graph in virtue of SPSS software. Results The relationship between propofol and isoflurane was accordance with exponential curve model,of which the equation is ：y = 102. 991 x exp（ -1. 4456x） , R^2 = 0.784;and the ratio of their dosages is 54/1. When isoflurane was inhaled alone at first, MAP was decreased significantly （ P 〈 0.05 ）. As the isoflurane concentration minished and the dosage of propofol added, MAP and HR were increasing gradually, but when isofhtrane concentration was minished to zero, there is no significant difference as compared with the preanesthesia baseline （ P 〉 0.05 ）. Conclusion When BIS was on the balanced level of 50 - 60, exponential curve relationship exists between the dosage of propofol and isoflurane concentration. If applied reasonablely, propofol could be good for reducing circulation side-effect of isoflurane.

关 键 词：麻醉药 联用 剂量效应关系 药物 丙泊酚 异氟烷 

分 类 号：R614[医药卫生—麻醉学]