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丙泊酚的全身麻醉效能及其对流体静压的依赖性。

The general anesthetic potency of propofol and its dependence on hydrostatic pressure.

作者信息

Tonner P H, Poppers D M, Miller K W

机构信息

Department of Anesthesia, Massachusetts General Hospital, Boston 02114.

出版信息

Anesthesiology. 1992 Nov;77(5):926-31. doi: 10.1097/00000542-199211000-00015.

DOI:10.1097/00000542-199211000-00015
PMID:1443748
Abstract

Although plasma concentrations of propofol during anesthesia are well known, the free concentration remains unknown because of uncertainties regarding plasma protein binding, interaction with other protein-bound substances, the level of binding to its lipid carrier, and the use of adjuvants. At elevated surrounding pressure, all general anesthetics require higher concentrations to reach adequate levels of anesthesia. To determine the anesthetic potency of propofol at equilibrium conditions and to study the effects of pressure on propofol-induced anesthesia, Rana pipiens tadpoles were exposed to different concentrations of pure, not emulsified, propofol in aqueous solution. Anesthesia was defined as loss of the righting reflex. Ten animals per concentration were used, and each experiment was conducted twice. Pressure experiments were performed with nonanesthetized tadpoles and urethane-anesthetized tadpoles as control groups. Propofol concentrations were measured spectrophotometrically. At 1 atmosphere absolute (atm abs), a semilogarithmic sigmoidal concentration-response curve was obtained with a half-maximal effect of propofol at 2.2 +/- 0.22 microM (EC50; mean +/- SE). Increased pressure shifted the concentration-response curve to the right. The EC50 increased linearly with increasing pressure up to 121 atm abs (EC50 at 121 atm abs = 4.1 +/- 0.41 microM). For pressure greater than 121 atm abs, an increased excitability of the tadpoles made it difficult to distinguish the righting reflex from involuntary movements. The saturated solubility of propofol in aqueous solution was found to be 1.0 +/- 0.02 mM (mean +/- SD), and the octanol/water partition coefficient was 4,300 +/- 280. Propofol adhered to the correlation between anesthetic potency and octanol/water partition coefficient exhibited by other general anesthetics.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

尽管麻醉期间丙泊酚的血浆浓度已为人熟知,但由于血浆蛋白结合、与其他蛋白结合物质的相互作用、与脂质载体的结合水平以及佐剂的使用存在不确定性,其游离浓度仍不清楚。在周围压力升高时,所有全身麻醉剂都需要更高的浓度才能达到足够的麻醉水平。为了确定平衡条件下丙泊酚的麻醉效能并研究压力对丙泊酚诱导麻醉的影响,将牛蛙蝌蚪暴露于不同浓度的纯丙泊酚(非乳化)水溶液中。麻醉定义为翻正反射消失。每个浓度使用10只动物,每个实验进行两次。以未麻醉的蝌蚪和氨基甲酸乙酯麻醉的蝌蚪作为对照组进行压力实验。用分光光度法测量丙泊酚浓度。在1个绝对大气压(atm abs)下,获得了一条半对数S形浓度-反应曲线,丙泊酚的半数最大效应浓度为2.2±0.22微摩尔(EC50;平均值±标准误)。压力增加使浓度-反应曲线右移。直至121 atm abs,EC50随压力增加呈线性增加(121 atm abs时的EC50 = 4.1±0.41微摩尔)。对于大于121 atm abs的压力,蝌蚪兴奋性增加,使得难以区分翻正反射与不自主运动。发现丙泊酚在水溶液中的饱和溶解度为1.0±0.02毫摩尔(平均值±标准差),辛醇/水分配系数为4300±280。丙泊酚符合其他全身麻醉剂所呈现的麻醉效能与辛醇/水分配系数之间的相关性。(摘要截短为250字)

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