手术病人丙泊酚的血药浓度测定及靶控输注系统评价  

Determination of the plasma propofol concentrations in surgical patients and evaluation of the target-controlled infusion system

作　　者：邢雷[1,2] 张延柳[1] 宫玉蕾[3] 周杰 李恩有[3] 曲福军[1] 

机构地区：[1]哈尔滨医科大学附属第二医院药学部,哈尔滨150086 [2]哈尔滨市第四医院药剂科,哈尔滨150026 [3]哈尔滨医科大学附属第一医院麻醉科,哈尔滨150001

出　　处：《药学服务与研究》2015年第2期134-137,共4页Pharmaceutical Care and Research

基　　金：国家自然科学基金(30972839)

摘　　要：目的：测定全身麻醉手术病人血浆中丙泊酚浓度,分析实测的病人血浆中丙泊酚浓度与靶控输注（target controlled infusion,TCI）系统预测的丙泊酚浓度的相关性,对TCI系统进行评价。方法：选择20例美国麻醉医师协会（ASA）评级为ASA1~ASA2级的全身麻醉手术病人,TCI系统丙泊酚的诱导浓度为6μg/ml;麻醉维持浓度分别为2.8、3.2、3.5、3.8μg/ml。HPLC法测定给药后不同时间病人血浆中的丙泊酚浓度。结果：麻醉诱导和维持阶段病人血浆中丙泊酚实测浓度高于靶控输注浓度,停止输注后实测浓度低于靶控输注浓度。TCI系统的偏离度（MDPE）和精密度（MDAPE）分别为6.0%和6.2%。病人脑电双频指数、反应熵和状态熵受麻醉影响明显。结论：TCI系统在麻醉指标监测下,可为临床用药提供参考。Objective：To determine the plasma concentration of propofol in surgical patients under general anesthesia,and also to analyze the relationship between actually measured concentrations and predicted concentrations of the target-controlled infusion（TCI）,so as to evaluate the effectiveness of the TCI system.Methods：Twenty surgical patients under general anesthesia with American Society of Anesthesiology（ASA）evaluation scores of ASA1-ASA2 were enrolled for the study.In the TCI system,the induction concentration of propofol was 6μg/ml,and the maintenance concentrations of propofol were 2.8,3.2,3.5and 3.8μg/ml,respectively.Propofol concentrations in plasma were detected after medication at various time points by HPLC method.Results：The actually measured concentrations of propofol in plasma both at induction and maintenance stages were higher than those of the TCI.Upon completion of infusion,the actually measured concentrations were lower than those of the TCI.The median performance error（MDPE）and median absolute performance error（MDAPE）of the TCI system were 6.0%and 6.2%,respectively.Bispectral index,response entropy and state entropy of the patients were obviously affected by anesthesia.Conclusion：The TCI system with the monitoring of anesthetic indicators,could provide reference for clinical medication.

关 键 词：丙泊酚 血药浓度 靶控输注系统 色谱法 高效液相 

分 类 号：R969[医药卫生—药理学] R971.2[医药卫生—药学]