呼出气监测静脉麻醉药血药浓度  

Breath Monitoring of Intravenous Anesthetics Concentration in Blood

作　　者：董浩[1] 张冯江[2] 林丽泉 陈璟[1] 王福园 王莹莹[1] 陈星[1] 

机构地区：[1]浙江大学生物医学工程与仪器科学学院,浙江杭州310027 [2]浙江大学医学院附属第二医院,浙江杭州310005

出　　处：《中国医疗设备》2016年第2期18-20,30,共4页China Medical Devices

基　　金：国家自然科学基金项目(No.81201166;No.81571769)

摘　　要：丙泊酚静脉麻醉药约占70%的临床手术麻醉用药量。且随着全凭静脉麻醉临床应用的深入研究,精确闭环麻醉的需求日益凸显。精确闭环静脉麻醉需要对麻醉药用量,手术麻醉效果以及麻醉预后进行快速监测和综合评价。由于静脉麻醉药经由静脉注射给药,实时血药浓度难以精确监测,这成为了精确闭环麻醉的瓶颈。基于呼出气实时监测丙泊酚血药浓度的研究在近十年内快速发展,新的技术和方法不断涌现,有望在短期内突破上述瓶颈。本文结合实验室的新近研究,介绍了快速气相色谱(GC)联用声表面波(SAW)传感器的在线检测呼出气体中丙泊酚浓度的系统和方法。通过固相微萃取气质联用对GC-SAW系统进行标定和校正,从而验证本系统的可行性、可靠性、检测极限和线性。通过初步临床实验比较了靶控输注(TCI)被试者呼出气中与血液中的丙泊酚浓度,以及比较了呼出气中丙泊酚浓度与TCI计算的血药浓度,结果均显示了高度的一致性。因此,GC-SAW系统是一种临床在线监测呼出气中丙泊酚含量的较为可靠的途径,它提供了一种便捷、快速的方法来精确地监测丙泊酚的剂量,这种监测方法可以减少患者在静脉麻醉时的丙泊酚的副作用。Propofol accounts for about 70% market share of intravenous anesthetics in clinical surgery. With further research and application of total intravenous anesthesia, precision closed-loop anesthesia is proved to be important in clinical practice. It is necessary to monitor anesthetic dose, assess anesthesia effect, and evaluate anesthesia prognosis in a rapid and comprehensive way during the closed-loop anesthesia. Due to intravenous injection of anaesthetic, the difficulty to precisely monitor anaesthetic dose in blood has become the main limit for development of precision closed-loop anesthesia. In recent ten years, propofol detection using real-time breath monitoring developed rapidly with novel techniques and methods, which might break through the barrier of the closed-loop anesthesia. This study presents systems and methods using synchronized applications of gas chromatograph（GC） and surface acoustic wave（SAW） sensor for on-line monitoring of propofol in exhaled gas. SPME-GC-MS was used to calibrate to GC-SAW sensor system for verifying feasibility, reliability, detection limit, and linearity. The propofol concentrations in exhaled gas was compared with concentrations in blood calculated by target-controlled infusion（TCI）. The results showed a high degree of consistency. In conclusion, GC-SAW system was proved to be a reliable way for clinical monitoring of propofol concentration through patients＇ exhaled gas.This detection system would reduce the side effects of propofol intravenous anesthesia during surgery.

关 键 词：呼吸检测 气相色谱联用声表面波 丙泊酚 靶控输注 

分 类 号：R318.6[医药卫生—生物医学工程]