Campbell L, Imrie G, Doherty P, Porteous C, Millar K, Kenny G N C, Fletcher G
Department of Anaesthetics, The Royal Sussex County Hospital, Eastern Road, Brighton, BN2 5BE, UK.
Anaesthesia. 2004 Feb;59(2):127-32. doi: 10.1111/j.1365-2044.2004.03580.x.
In this study, we evaluated safety and recovery using a patient maintained, target controlled infusion of propofol for sedation in 20 patients undergoing colonoscopy. Using a handset with a two-minute lockout interval, patients could make 0.2 micro g.ml(-1) increments to an initial target plasma concentration of 1 micro g.ml(-1) up to a maximum 4.5 micro g.ml(-1). Four patients became oversedated but required no airway or circulatory interventions. Subjects had a significant reduction in mean (SD) heart rate: 78.7 (15) vs. 69.8 (13.5) (p < 0.001) and in systolic blood pressure 121.1 (13.2) mmHg vs. 96.5 (8.6) mmHg (p < 0.001). Choice reaction time testing 15 min after colonoscopy showed a significant median (IQR [range]) rise of 162 (- 16, 383.3 [-199-859]) ms (p < 0.05). Six patients had faster reaction times postcolonoscopy. All patients denied unpleasant recall and were satisfied with the system. Although oversedation was a problem in this model, we conclude that patient maintained propofol sedation could be possible for colonoscopy.
在本研究中，我们对20例接受结肠镜检查的患者使用患者自控靶控输注丙泊酚进行镇静，评估其安全性和恢复情况。使用具有两分钟锁定间隔的手持装置，患者可以将初始目标血浆浓度1μg/ml以0.2μg/ml的增量进行调整，最高可达4.5μg/ml。4例患者出现过度镇静，但无需气道或循环干预。受试者的平均（标准差）心率显著降低：78.7（15）次/分钟对69.8（13.5）次/分钟（p<0.001），收缩压从121.1（13.2）mmHg降至96.5（8.6）mmHg（p<0.001）。结肠镜检查后15分钟的选择反应时间测试显示，中位数（四分位间距[范围]）显著增加了162（-16,383.3[-199-859]）毫秒（p<0.05）。6例患者结肠镜检查后的反应时间更快。所有患者均否认有不愉快的回忆，并对该系统感到满意。虽然在该模型中过度镇静是一个问题，但我们得出结论，患者自控丙泊酚镇静用于结肠镜检查是可行的。
