静吸复合全麻时靶控输注低浓度舒芬太尼的准确性评价  

Evaluation of accuracy of target-controlled infusion of sufentanil at low concentration during combined intravenous and inhalational general anesthesia

作　　者：赵艳[1,2] 王玉洁[2] 邱维吉[1] 熊歆 Zhao Yan;Wang Yujie;Qiu Weiji;Xiong Xin(Department of Anesthesiology and Perioperative Medicine,Shanghai Fourth People's Hospital Affiliated to Tongji University,Shanghai 200081,China;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]同济大学附属上海市第四人民医院麻醉与围术期医学科,200081 [2]北京大学第三医院麻醉科,100191 [3]北京大学第三医院药剂科,100191

出　　处：《中华麻醉学杂志》2020年第8期970-973,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价静吸复合全麻时靶控输注(TCI)低浓度舒芬太尼的准确性。方法择期全麻手术患者30例,ASA分级Ⅰ或Ⅱ级,年龄18~68岁,BMI<35 kg/m^2。全麻诱导应用舒芬太尼TCI、丙泊酚和罗库溴铵,麻醉维持复合TCI舒芬太尼和吸入七氟烷。运用随机数序列法随机分为2组(n=15):0.10 ng/ml组(Ⅰ组)和0.15 ng/ml组(Ⅱ组)。经桡动脉取血样,液相色谱-质谱联用法检测血浆舒芬太尼浓度。计算偏离度、精确度和摆动度。结果Ⅰ组和Ⅱ组偏离度分别为17.0%和-3.0%,精确度分别为22.4%和20.3%,摆动度分别为23.0%和21.7%。总体偏离度、精确度和摆动度分别是6.0%、22.0%和22.0%。结论静吸复合全麻时TCI低浓度舒芬太尼的准确性在临床可接受范围内,舒芬太尼实测血药浓度较靶浓度高约6%。Objective To evaluate the accuracy of target-controlled infusion(TCI)of sufentanil at low concentration during combined intravenous and inhalational general anesthesia.Methods Thirty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 18-68 yr,with body mass index <35 kg/m^2,scheduled for elective laparoscopic surgery under combined intravenous and inhalational general anesthesia,were selected in the study.Anesthesia was induced with sufentanil TCI,propofol and rocuronium and maintained with sufentanil TCI combined with inhalation of sevoflurane.The patients were divided into 2 groups(n=15 each)using the computer-generated sequence of random numbers method:0.10 ng/ml group(group Ⅰ)and 0.15 ng/ml group(group Ⅱ).Arterial blood samples were collected from the radial artery for determination of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry.The bias,precision and wobble were calculated.Results In Ⅰ and Ⅱ groups,the bias of sufentanil TCI was 17.0% and -3.0%,respectively,the precision was 22.4% and 20.3%,respectively,and the wobble was 23.0% and 21.7%,respectively.The pooled bias,precision and wobble were 6.0%,22.0% and 22.0%,respectively.Conclusion The accuracy of TCI of sufentanil at low concentration during combined intravenous and inhalational general anesthesia is within the clinically acceptable range,and the measured blood concentration of sufentanil is about 6% higher than the target concentration.

关 键 词：麻醉 全身 舒芬太尼 药物释放系统 

分 类 号：R614[医药卫生—麻醉学]