患者自控-靶控输注系统输注舒芬太尼的准确性评价  

Evaluation of the accuracy of patient controlled-target controlled infusion system with sufentanil

作　　者：叶飞[1] 奚彬[2] 佘守章[2] 肖建斌[1] 招伟贤[1] 许立新[2] 许学兵[2] 

机构地区：[1]广东省中医院麻醉科,广州510120 [2]广州市第一人民医院麻醉科,510180

出　　处：《广东医学》2009年第2期279-281,共3页Guangdong Medical Journal

基　　金：广东省广州市医药卫生科技重点项目(编号2006-ZDi-01)

摘　　要：目的通过测定舒芬太尼血药浓度的方法来评价患者自控-靶控输注(PC-TCI)系统的准确性。方法选择拟行气管内全麻下择期腹部手术的患者15例(ASAⅠ～Ⅱ级),于手术麻醉期间应用PC-TCI系统输注舒芬太尼,采用酶联免疫方法(Elisa)检测其血浆舒芬太尼浓度;选择执行误差(PE)的中位数(MDPE)、PE绝对中位数(MDAPE)、分散度和摆动度作为评价其准确性的指标。结果MDPE、MDAPE、分散度、摆动度的中位数(95%可信区间)分别为-9.5%(-12.1%～-7.3%)、10.5%(7.5%～12.2%)、-2.5%/h(-6.8%/h～4.9%/h)、17.5%(10.3%～25.6%)。实测血药浓度与预测血药浓度呈线性相关(R2=0.9453)。结论患者自控-靶控输注系统的偏离度较小,精密度较高,而分散度较小,能维持较稳定的血药浓度,适合临床应用。Objective To evaluate the accuracy of the patient controlled -target controlled infusion （PC -TCI） system with sufentanil by detecting plasma drug concentration. Methods Fifteen patients with ASA grade Ⅰ - Ⅱ scheduled for selective abdominal surgery under general anesthesia received PC - TCI with sufentanil. The plasma concentration of sufentanil was measured by enzyme - linked immunosorbent assay （ELISA）. Performance was determined by the median performance error （MDPE） , the mean absolute performance error （MDAPE） , the divergence and the wobble. Results The median （95% confidence interval） of MDPE, MDAPE, the divergence and the wobble was -9.5% （ -12.1% - -7.3%）,10.5% （7.5%-12.2%）,-2.5%/h （-6.8%/h-4.9%/h） and 17.5% （10.3% -25.6%） respectively. The detected and the estimated plasma concentration of sufentanil was in linear correlation （ R^2 = 0.945 3 ）. Conclusions Blood plasma concentration of sufentanil is stable in patients using the PC -TCI system, suggesting its suitability for clinical use.

关 键 词：舒芬太尼 药代动力学 患者控制 靶控输注 

分 类 号：R614.4[医药卫生—麻醉学] R614.24[医药卫生—外科学]