Matsumoto E, Yamasaki K, Nakata K, Hazama A, Kita T, Mammoto T, Kambara N, Sakai T, Kishi Y
Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases.
Masui. 2000 Oct;49(10):1103-8.
Twenty patients were prospectively and randomly studied to investigate effects of infusion methods of propofol on quality of sedation and ease of sedation control during gynecological laparotomy under spinal anesthesia. After establishment of spinal anesthesia, patients were randomly assigned to one of the following two groups, i.e. conventional continuous infusion group (Cont group) and target-controlled infusion group (TCI group). In the Cont group, propofol was started at a rate of 6 mg.kg-1.hr-1 until response to command disappeared. In the TCI group, the initial target concentration of propofol was set at 1.2 micrograms.ml-1 until response to command disappeared. Thereafter infusion rate or target concentration was adjusted to maintain Mackenzie's score at 3 or 4. Predicted concentration of propofol was 1.2 +/- 0.01 micrograms.ml-1 at induction of sedation and 1.2 +/- 0.11 micrograms.ml-1 during stable sedation in the TCI group. Satisfaction VAS, anxiety VAS, discomfort VAS, sedation score and times of changing infusion condition were similar in both groups. Total dose of propofol was significantly less in the TCI group. In conclusion, quality of sedation and ease of control of sedation were comparable in both groups and continuous infusion method is simple.
对20例患者进行前瞻性随机研究，以探讨丙泊酚输注方法对腰麻下妇科剖腹手术镇静质量及镇静控制难易程度的影响。腰麻建立后，患者被随机分为以下两组，即传统持续输注组（Cont组）和靶控输注组（TCI组）。Cont组中，丙泊酚以6mg·kg-1·h-1的速率开始输注，直至对指令的反应消失。TCI组中，丙泊酚的初始靶浓度设定为1.2μg·ml-1，直至对指令的反应消失。此后调整输注速率或靶浓度，以维持麦肯齐评分在3或4分。TCI组在镇静诱导时丙泊酚的预测浓度为1.2±0.01μg·ml-1，在稳定镇静期间为1.2±0.11μg·ml-1。两组的满意度视觉模拟评分（VAS）、焦虑VAS、不适VAS、镇静评分及改变输注条件的次数相似。TCI组丙泊酚的总剂量显著较少。总之，两组的镇静质量和镇静控制难易程度相当，持续输注方法简单。
