不同靶浓度普鲁泊福对上腹部手术病人七氟烷呼气末有效浓度的影响  

Effects of different target plasma concentrations of propofol by target-controlled ifusion on end-tidal sevoflurane concentration

作　　者：王世端[1] 冀翔宇[1] 黄辉[1] 梁永新[1] 滕如阳[1] 赵洋[1] 

机构地区：[1]青岛大学医学院附属医院麻醉科,山东青岛266003

出　　处：《中国临床药理学杂志》2009年第1期14-17,共4页The Chinese Journal of Clinical Pharmacology

基　　金：青岛市科技发展计划基金资助项目(Kzd71)

摘　　要：目的观察不同靶浓度普鲁泊福(短效静脉麻醉药)对上腹部手术患者七氟烷(吸入麻醉药)呼气末有效浓度的影响。方法60例择期上腹部手术的病人随机分为3组:S组,麻醉诱导后,单纯吸入七氟烷维持麻醉;P1组和P2组在吸入七氟烷的同时,分别输注靶浓度为1、2μg·mL-1的普鲁泊福。麻醉诱导气管插管后,启动靶控输注普鲁泊福,并根据脑电双频谱指数(BIS)值的变化调节七氟烷吸入浓度,维持BIS值在45～55。结果呼气末七氟烷有效浓度S组为(1.74±0.14)%,P1组为(1.24±0.08)%,P2组为(0.82±0.09)%,P1组较S组降低28.7%;P2组较S组降低52.9%,P1组的血压更稳定。结论复合1、2μg·mL-1靶浓度的普鲁泊福,七氟烷的呼气末浓度分别下降28.7%和52.9%;以靶浓度为1μg·mL-1的普鲁泊福与七氟烷复合麻醉,对稳定血流动力学更有效。Objective To investigate the effects of different target plasma concentrations of propofol given by target - controlled ifusion （TCI） on end -tidal sevoflurane concentration. Methods Sixty ASA Ⅰ or Ⅱ patients undergoing elective upper abdominal surgery under general anesthesia were randomly allocated to one of three groups with 20 patients in each group ： group S, sevoflurane ; group P1, sevoflurane ＋ TCI propofol （1μg · mL^-1） and group P2; sevoflurane ＋ TCI propofol （2 μg · mL^- 1 ）. Anesthesia was induced with midazolm 0.05 mg· kg^-1, fentanyl 3 μg · kg ^-1 propofol 0.5 - 1.0 mg · kg^- 1. Tracheal intubation was facilitated with vecuronium 0.12 mg · kg^-1. After intubation anesthesia was maintained with sevoflurane inhalation alone （group Ⅰ ） or sevoflurane combined with TCI propofol at target plasma concentration of 1 μg · mL^-1 （ group P1 ） or 2 μg · mL^ -1 （ group P2）. Bispectral index （BIS） was maintained at 45 - 55 after tracheal intubation during maintenance of anesthesia. Results When BIS was maintained at 50 ± 5, the end - tidal sevoflurane concentration was （ 1.74 ± 0. 14） % （ group S ）, （ 1.24 ± 0.08 ） % （ group S） and （0.82 ± 0. 09 ） % （ group P2 ）, respectively. There was no singnificant difference in the heart rate at each time point among three groups, but arterial pressure was lower in the group P1 than that of two other groups. Conclusion At the same depth of anesthesia （ BIS = 50 ± 5 ）, the end - tidal sevoflurane concentration was greatly reduced when combined with TCI propofol, and TCI 1 μg · mL^-1 propofol combined with sevoflurane can provides stable hemodynamic condition.

关 键 词：普鲁泊福 药物释放系统 七氟烷 吸入麻醉 

分 类 号：R656[医药卫生—外科学] R614.21[医药卫生—临床医学]