Murdoch J A, Kenny G N
University Department of Anaesthesia, Glasgow Royal Infirmary, UK.
Br J Anaesth. 1999 Mar;82(3):429-31. doi: 10.1093/bja/82.3.429.
We have assessed the efficacy and safety of a system which allowed 20 patients undergoing day-case anaesthesia to operate a target-controlled infusion of propofol to provide anxiolytic premedication. A target-controlled infusion of propofol was started with a target blood concentration of 1 microgram ml-1, and the patient was allowed to increase the target by 0.2 microgram ml-1 by operating a control button. There was a lockout time of 2 min and a maximum target concentration of 3 micrograms ml-1. There were significant reductions in anxiety scores from presedation baseline values and those measured at 15 min after the start of sedation. Values remained low until induction of anaesthesia. Median blood target concentration of propofol varied from 1.0 to 1.2 micrograms ml-1 and mean propofol consumption was 50.3 (SD 17.6) micrograms kg-1 min-1. No patient became oversedated and all remained cardiovascularly stable. Two individuals required low-dose supplementary oxygen for mild arterial oxygen desaturation but there were no instances of airway obstruction. Patient satisfaction with the system was high.
我们评估了一种系统的疗效和安全性，该系统允许20名接受日间手术麻醉的患者操作丙泊酚靶控输注以提供术前镇静。丙泊酚靶控输注开始时目标血药浓度为1微克/毫升，患者可通过操作控制按钮将目标浓度提高0.2微克/毫升。锁定时间为2分钟，最大目标浓度为3微克/毫升。与镇静前基线值以及镇静开始后15分钟时测得的焦虑评分相比，焦虑评分有显著降低。在麻醉诱导前，数值一直保持较低水平。丙泊酚的血药目标浓度中位数在1.0至1.2微克/毫升之间，丙泊酚的平均消耗量为50.3（标准差17.6）微克/千克·分钟。没有患者出现过度镇静，所有患者心血管状况均保持稳定。两名患者因轻度动脉血氧饱和度降低需要低剂量补充氧气，但未出现气道梗阻情况。患者对该系统的满意度较高。
