两种丙泊酚靶控输注药代模型在老年患者眼底手术镇静中的对比研究  

Propofol TCI sedation in eye fundus operation:a comparison of two pharmacokinetic models in elderly patients

作　　者：徐源[1] 范雪梅[1] 李天佐[1] 

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,100730

出　　处：《北京医学》2012年第8期651-653,共3页Beijing Medical Journal

基　　金：北京医药产品和技术重大项目培育研究(Z101107050210030)

摘　　要：目的比较两种丙泊酚靶控输注药代/药效模型Marsh、Schnider在老年患者眼底手术镇静中的应用。方法 65岁以上眼底手术患者42例,随机分为M组、S组,分别使用Marsh、Schnider模型,以靶控输注丙泊酚血浆浓度0.4μg/ml为起点,达到靶控浓度目标值后每分钟增加0.1μg/ml,直至达到OAA/S评分3分。记录此时个体的丙泊酚血浆浓度、效应室浓度、脑电双频指数(BIS)值、无创血压、心率、脉搏血氧饱和度。结果 OAA/S评分3分时,丙泊酚血浆浓度EC95Schnider模型高于Marsh模型(P<0.05);效应室浓度EC50和EC95Schnider模型均高于Marsh模型(P<0.05);两组患者血压均明显低于入室基础值(P<0.05)。结论老年患者使用丙泊酚靶控镇静,在OAA/S评分3分时,丙泊酚Marsh模型效应室浓度低于Schnider模型效应室浓度。Objective To compare the two PK/PD models, Marsh and Schnider, with propofol TCI sedation in elderly patients with eye fundus operation. Methods Forty-two patients who were older than 65 years old and underwent selective eye fundus operation were randomized into two groups, the M group and the S group. Patients were sedated with propofol by Marsh and Schnider TCI model. The propofol was started at a plasma concentration of 0.4μg/ml, and increased by 0.1 μg/ml every one min until the score was 3 based on the OAAS score. Probity regression was used to estimate population values for the two PK/PD models. Results Plasma concentration EC95 was higher with Sehnider model than Marsh model. The effect-site concentration of EC50 and EC95 was higher with the Sehnider model than the Marsh model. Conclusion In elderly patients, if the OAA/S score 3 is taken as the end point, the effect-site concentrations of propofol are 0.8 μg,/ml and 1.2 μg/ml respectively with Marsh model and Sehnider model.

关 键 词：老年 眼底手术 丙泊酚 靶控输注 药代/药效模型 效应室浓度 

分 类 号：R614[医药卫生—麻醉学]