Onaka M, Yamamoto H, Akatsuka M, Mori H
Department of Anesthesiology, Osaka Medical College, Takatsuki.
Masui. 1999 Oct;48(10):1126-31.
Total intravenous anesthesia (TIVA) is recommended to avoid air pollution. However, intermittent administration of anesthetic agents has a large disadvantage of delayed emergence time. We suggested continuous TIVA with propofol, ketamine, vecuronium and buprenorphine (PKBp), and reported that maintenance with continuous intravenous administration of propofol corresponding to the age associated with ketamine (240 micrograms.kg-1.h-1), vecuronium (80 micrograms.kg-1.h-1) and buprenorphine (0.4 microgram.kg-1.h-1) brought rapid emergence and that the last 1/6 of anesthetic time was the point to reduce propofol maintenance dose. In this study, we maintained anesthesia with continuous intravenous administration of propofol using twice step down method every one hour. We conclude that the reduction of propofol maintenance dose for every 1/6 in one hour produces fewer dropout cases.
推荐采用全静脉麻醉（TIVA）以避免空气污染。然而，间断给予麻醉剂有苏醒时间延迟这一重大缺点。我们建议采用丙泊酚、氯胺酮、维库溴铵和丁丙诺啡（PKBp）进行持续全静脉麻醉，并报告称，以与氯胺酮相关的年龄对应的丙泊酚（240微克·千克⁻¹·小时⁻¹）、维库溴铵（80微克·千克⁻¹·小时⁻¹）和丁丙诺啡（0.4微克·千克⁻¹·小时⁻¹）持续静脉给药维持麻醉可实现快速苏醒，且麻醉时间的最后1/6是降低丙泊酚维持剂量的时间点。在本研究中，我们每小时采用两步递减法通过丙泊酚持续静脉给药维持麻醉。我们得出结论，每小时将丙泊酚维持剂量减少1/6可减少退出病例。
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