Jones D, Prankerd R, Lang C, Chilvers M, Bignell S, Short T
Department of Anaesthesiology and Intensive Care, University of Queensland, Royal Brisbane Hospital, Queensland.
Anaesth Intensive Care. 1999 Aug;27(4):346-56. doi: 10.1177/0310057X9902700403.
This study examined some pharmacodynamic characteristics of two admixtures of propofol and thiopentone. Ninety unpremedicated ASA 1 or 2 patients were group-randomized to receive, in a double-blinded manner, one of the following mixtures for induction of anaesthesia: Group P50: propofol 1% 10 ml/thiopentone 2.5% 10 ml; Group P75: propofol 1% 15 ml/thiopentone 2.5% 5 ml; Group P100: propofol 1% 20 ml/lignocaine 1% 4 ml. An additional 30 randomized but unblinded patients from the same patient cohort received thiopentone 2.5% to provide predictive dose data for groups P50 and P75. Haemodynamic data were collected pre- and post-induction. The required induction dose of both mixtures of propofol and thiopentone found an additive rather than a synergistic interaction with no significant difference between predicted and observed dose. Thiopentone resulted in significantly more rapid induction of anaesthesia than propofol/lignocaine or propofol/thiopentone. The addition of thiopentone to propofol was found to be as efficacious as the mixing of lignocaine with propofol in reducing pain on injection. The fall in systolic blood pressure was significantly less in group P50 compared with groups P75 or P100. Admixture of thiopentone with propofol results in an additive hypnotic effect, a reduction in pain of injection (comparable with addition of lignocaine) and a reduced hypotensive response compared to propofol injection alone during induction.
本研究考察了丙泊酚与硫喷妥钠两种混合制剂的一些药效学特性。90例未使用术前药的ASA 1或2级患者被分组随机化，以双盲方式接受以下用于诱导麻醉的混合制剂之一：P50组：1%丙泊酚10 ml/2.5%硫喷妥钠10 ml；P75组：1%丙泊酚15 ml/2.5%硫喷妥钠5 ml；P100组：1%丙泊酚20 ml/1%利多卡因4 ml。另外30例来自同一患者队列的随机但非盲患者接受2.5%硫喷妥钠，以提供P50组和P75组的预测剂量数据。在诱导前和诱导后收集血流动力学数据。丙泊酚与硫喷妥钠两种混合制剂所需的诱导剂量显示为相加作用而非协同作用，预测剂量与观察剂量之间无显著差异。硫喷妥钠导致的麻醉诱导比丙泊酚/利多卡因或丙泊酚/硫喷妥钠更快。发现在丙泊酚中添加硫喷妥钠在减轻注射疼痛方面与在丙泊酚中混合利多卡因一样有效。与P75组或P100组相比，P50组收缩压下降明显较少。在诱导期间，硫喷妥钠与丙泊酚混合产生相加的催眠作用，减轻注射疼痛（与添加利多卡因相当），并且与单独注射丙泊酚相比，降低了低血压反应。
