Joshi Shailendra, Wang Mei, Etu Joshua J, Pile-Spellman John
Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
Anesth Analg. 2006 Jun;102(6):1816-22. doi: 10.1213/01.ane.0000202523.94060.47.
We hypothesized that an intracarotid bolus injection of propofol to produce electroencephalographic (EEG) silence would require a smaller dose of the drug compared with the continuous infusion of the drug. Furthermore, the bolus propofol dose will be a function of the bolus characteristics in each bolus (mass/volume). We compared the dose requirements of intracarotid propofol needed to maintain EEG silence when delivered as bolus injections to continuous infusions in rabbits. Subsequently, we compared whether four different bolus characteristics (concentration and volume) of propofol (0.33% x 0.1 mL, 0.33% x 0.3 mL, 1% x 0.1 mL, and 1% x 0.3 mL) affected the dose required to produce EEG silence. We found that the infusion rate of propofol required to sustain EEG silence was three-fold larger than the dose required by bolus injections, 22.8 +/- 11.9 vs 6.2 +/- 2.9 mL/h for infusion versus bolus, respectively (n = 7, P < 0.004). Furthermore, during bolus injection, the doses of propofol required to produce EEG silence were a direct function of the bolus volume and the mass of drug in each bolus, total dose = 3.6 + 29 x mg/bolus, n = 32, r = 0.85. For maximum regional effects of the bolus intracarotid drug injection, the bolus characteristics (volume and drug concentration) have to be optimized.
我们假设,与持续输注丙泊酚相比,经颈动脉推注丙泊酚以产生脑电图(EEG)静息所需的药物剂量更小。此外,丙泊酚推注剂量将取决于每个推注的特性(质量/体积)。我们比较了在兔体内以推注方式给药与持续输注时维持EEG静息所需的颈动脉内丙泊酚剂量。随后,我们比较了丙泊酚的四种不同推注特性(浓度和体积)(0.33%×0.1 mL、0.33%×0.3 mL、1%×0.1 mL和1%×0.3 mL)是否会影响产生EEG静息所需的剂量。我们发现,维持EEG静息所需的丙泊酚输注速率比推注所需剂量大三倍,输注和推注分别为22.8±11.9与6.2±2.9 mL/h(n = 7,P < 0.004)。此外,在推注期间,产生EEG静息所需的丙泊酚剂量直接取决于推注体积和每个推注中的药物质量,总剂量 = 3.6 + 29×mg/推注,n = 32,r = 0.85。为了使颈动脉推注药物注射产生最大区域效应,必须优化推注特性(体积和药物浓度)。