靶控输注低浓度舒芬太尼的准确性评价  

Accuracy evaluation of target-controlled infusion of sufentanil at low concentration

作　　者：赵艳[1] 唐慧敏[1] 郭向阳[1] 熊歆[2] 翟所迪[2] Zhao Yan;Tang Huimin;Guo Xiangyang;Xiong Xin;Zhai Suodi(Department of Anesthesiology,Peking University Third Hospital,Beijing 100191,China;Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院麻醉科,100191 [2]北京大学第三医院药剂科,100191

出　　处：《中华麻醉学杂志》2019年第5期586-589,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价靶控输注(TCI)低浓度舒芬太尼的准确性。方法择期全麻手术患者60例,ASA分级Ⅰ或Ⅱ级,年龄18~68岁。全麻诱导和维持采用TCI舒芬太尼和丙泊酚。采用密闭信封法随机分为3组(n=20):0.08 ng/ml组(Ⅰ组)、0.10 ng/ml组(Ⅱ组)和0.12 ng/ml组(Ⅲ组)。每组随机选取10例患者,经桡动脉取血样,采用液相色谱-质谱联用法测定血浆舒芬太尼浓度。通过计算偏离度、精确度和摆动度,评价舒芬太尼TCI的准确性。结果Ⅰ组、Ⅱ组和Ⅲ组偏离度分别为-6.1%、-10.2%和-5.0%,精确度分别为19.4%、15.8%和14.2%,摆动度分别为20.9%、11.0%和10.8%。总体偏离度、精确度和摆动度分别为-7.1%、16.8%和13.5%。结论TCI低浓度舒芬太尼的准确性在临床麻醉可接受范围内,舒芬太尼实测血药浓度较靶浓度低约7%。Objective To evaluate the accuracy of target-controlled infusion(TCI)of sufentanil at low concentration.Methods Sixty patients with American Society of Anesthesiologists physical statusⅠorⅡ,aged 18-68 yr,scheduled for elective surgery under general anesthesia,were included in this study.Anesthesia was induced and maintained with sufentanil TCI combined with propofol TCI,and muscle relaxation was maintained by intermittent injection of rocuronium as needed.The patients were divided into 3 groups(n=20 each)using the sealed envelope method:0.08 ng/ml group(groupⅠ),0.10 ng/ml group(groupⅡ)and 0.12 ng/ml group(groupⅢ).Arterial blood samples were collected in 10 patients randomly selected from each group for measurement of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry.The accuracy of sufentanil TCI was evaluated by calculating bias(median performance error),precision(median absolute performance error)and wobble.Results InⅠ,ⅡandⅢgroups,the bias of sufentanil TCI was-6.1%,-10.2%and-5.0%,respectively,the precision was 19.4%,15.8%and 14.2%,respectively,and the wobble was 20.9%,11.0%and 10.8%,respectively.The pooled bias,precision and wobble were-7.1%,16.8%and 13.5%inⅠ,ⅡandⅢgroups,respectively.Conclusion The accuracy of sufentanil TCI at low concentration is considered acceptable in clinical anesthesia,and the measured plasma sufentanil concentration is approximately 7%lower than the target plasma sufentanil concentration in surgical patients.

关 键 词：药物释放系统 舒芬太尼 

分 类 号：R61[医药卫生—外科学]