Hutchens Michael P, Memtsoudis Stavros, Sadovnikoff Nicholas
Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR 97239, USA.
Neurocrit Care. 2006;4(1):54-62. doi: 10.1385/NCC:4:1:054.
Interventions in the intensive care unit often require that the patient be sedated. Propofol is a widely used, potent sedative agent that is popular in critical care and operating room settings. In addition to its sedative qualities, propofol has neurovascular, neuroprotective, and electroencephalographical effects that are salutory in the patient in neurocritical care. However, the 15-year experience with this agent has not been entirely unbesmirched by controversy: propofol also has important adverse effects that must be carefully considered. This article discusses and reviews the pharmacology of propofol, with specific emphasis on its use as a sedative in the neuro-intensive care unit. A detailed explanation of central nervous system and cardiovascular mechanisms is presented. Additionally, the article reviews the literature specifically pertaining to neurocritical care use of propofol.
重症监护病房的干预措施通常需要对患者进行镇静。丙泊酚是一种广泛使用的强效镇静剂,在重症监护和手术室环境中很受欢迎。除了具有镇静作用外,丙泊酚还具有神经血管、神经保护和脑电图效应,这些对神经重症监护患者有益。然而,使用这种药物15年的经验并非完全没有争议:丙泊酚也有必须仔细考虑的重要不良反应。本文讨论并综述了丙泊酚的药理学,特别强调其在神经重症监护病房作为镇静剂的应用。文中还对中枢神经系统和心血管机制进行了详细解释。此外,本文还综述了专门涉及丙泊酚在神经重症监护中应用的文献。