舒芬太尼靶控输注系统维持血药浓度的准确性分析  

Analysis of the accuracy of infusion system to maintain the blood drug concentration of sufentanil in target control

作　　者：荣誉[1] 张锦英[1] 

机构地区：[1]辽宁医学院附属第一医院麻醉科,辽宁锦州121001

出　　处：《中国医院药学杂志》2014年第21期1848-1851,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探讨超高效液相-串联质谱法(UPLC-MS/MS)测定人血浆中舒芬太尼浓度评价舒芬太尼靶控输注系统的准确性。方法:选择2012年10月—2013年10月拟在我院行气管内全麻择期手术并符合纳入标准的患者135例,随机分为3组:A组(舒芬太尼0.2 ng·ml-1)、B组(舒芬太尼0.4 ng·ml-1)和C组(舒芬太尼0.6 ng·ml-1),每组45例。术中维持阶段舒芬太尼通过靶控输注(TCI)系统输注,在TCI开始(T0)及TCI后5 min(T1)、20 min(T2)、40 min(T3)、60 min(T4)、90 min(T5)和120 min(T6)时抽取全部患者桡动脉血,采用UPLC-MS/MS法检测血浆舒芬太尼浓度,以评价舒芬太尼TCI系统的执行情况。观察并记录3组患者T1~T4时间点的心率、平均动脉压等,与T0时间点进行比较。结果:A、B、C3组在T1~T4时间点的平均动脉压与T0时间点相比明显降低,差异具有统计学意义(P<0.05),但仍然在正常范围内;3组T1~T4时间点的心率与T0时间点相比差异无统计学意义(P>0.05);A组在T1、T2和T3时间点,B组在T3和T5时间点,C组在T2、T5时间点实测得的舒芬太尼血药浓度显著低于设定靶浓度(P<0.05);舒芬太尼TCI系统可以维持较为稳定的血药浓度,各参数都在临床可接受的范围内。结论:舒芬太尼通过TCI系统输注时实测血药浓度与设定的靶浓度存在执行误差,但该误差在临床可接受范围内,故舒芬太尼TCI系统的准确性较高,可安全有效地运用于全身麻醉的手术中。OBJECTIVE To explore and evaluate the accuracy of determination of human plasma sufentanil concentrations in target controlled infusion system by ultra performance liquid chromatography tandem mass spectrometry （UPLC-MS/MS）. METHODS 135 patients met the inclusion criteria from 2012 Oct.- 2013 Oct. in our hospital were selected for endotracheal general anesthesia and elective operation. They were randomly divided into 3 groups., group A （sufentanil 0. 2 ng·mL^-1 ）, group B （sufentanil 0. 4 ng·mL^-1 ） and group C （sufentanil 0.6 ng·mL^-1 ）, 45 patients in each group. In the operation mainte- nance phase, sufentanil was infused through the TCI system, in the beginning of TCI （T0） and TCI 5min （T0）, after 20 rain （T2）, 40min （T3） , 60 rain （T4）, 90 rain （T5） and 120 min （T6）, the blood was extracted from all of the patients radial artery. UPLC-MS/MS method was used to detect the plasma concentration of sufentanil for evaluation of the implementation of sufentanil TCI system. The heart rate, mean arterial pressure of the 3 groups of patients were observed and recorded at T1-T4 time points and compared to those of the T0 time point. RESULTS The mean arterial pressure of A, B, C three groups at the T1-T4 time points were significantly decreased as compared with that at T, time point , and had statistically significant differ- ence （P^0. 05）, but still within the normal range there was no statistically significant difference of heart rate at T1 time point in the three groups as compared with that at T1-T4 time points （P〉0. 05）. In group A at T1, T2 and T3 time points, in group B at T3 and T5 time points, in C group at T2, T3 time points, the sufentanil concentrations measured were significantly lower than the set target concentration of sufentanil （P〈0. 05） sufentanil TCI system could maintain stable blood concentration,the parameters were within acceptable range in clinic. CONCLUSION There is execution error existing between the measured plasma sufentanil co

关 键 词：舒芬太尼 靶控输注系统 超高效液相-串联质谱法 准确性评价 

分 类 号：R966[医药卫生—药理学]