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[靶控输注(TCI)——一个具有未来前景的概念?:最新技术水平、治疗建议及未来展望]

[Target-controlled infusion (TCI) - a concept with a future?: state-of-the-art, treatment recommendations and a look into the future].

作者信息

Schraag S, Kreuer S, Bruhn J, Frenkel C, Albrecht S

机构信息

Department of Perioperative Medicine, Golden Jubilee National Hospital, Beardmore Street, Clydebank, Glasgow, Scotland, UK.

出版信息

Anaesthesist. 2008 Mar;57(3):223-30. doi: 10.1007/s00101-008-1329-7.

DOI:10.1007/s00101-008-1329-7
PMID:18322665
Abstract

Over the last 10 years the technique of target-controlled infusion (TCI) has substantially influenced the development and practice of intravenous anaesthesia. It opened the possibility of many new and exciting applications of perioperative anaesthetic care. More recent and current developments, such as open TCI (target-controlled infusion) and the availability of generic anaesthetic agents combined with modern infusion pumps, means that TCI can become a standard procedure in anaesthesia and is no longer just a research tool for specialists and enthusiasts. This review explains the fundamentals and applications of intravenous drug delivery by TCI and gives practice guidelines to successfully implement the technique into clinical practice. The aim is to provide a comprehensive reference based on clinically proven evidence.

摘要

在过去十年中,靶控输注(TCI)技术对静脉麻醉的发展与实践产生了重大影响。它为围手术期麻醉护理带来了许多新颖且令人兴奋的新应用可能性。最近以及当前的发展,如开放式TCI(靶控输注)以及通用麻醉剂与现代输液泵的可得性,意味着TCI能够成为麻醉中的标准操作程序,而不再仅仅是专家和爱好者的研究工具。本综述解释了通过TCI进行静脉药物输注的基本原理和应用,并给出了将该技术成功应用于临床实践的操作指南。目的是基于临床验证的证据提供一份全面的参考资料。

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[Target-controlled infusion (TCI) - a concept with a future?: state-of-the-art, treatment recommendations and a look into the future].[靶控输注(TCI)——一个具有未来前景的概念?:最新技术水平、治疗建议及未来展望]
Anaesthesist. 2008 Mar;57(3):223-30. doi: 10.1007/s00101-008-1329-7.
2
[Target controlled infusion (TCI)--status and clinical perspectives].[靶控输注(TCI)——现状与临床展望]
Anasthesiol Intensivmed Notfallmed Schmerzther. 2000 Jan;35(1):12-20. doi: 10.1055/s-2000-10845.
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Intravenous anaesthesia: manual infusion schemes versus TCI systems.静脉麻醉:手动输注方案与靶控输注系统
Anaesthesia. 1998 Apr;53 Suppl 1:42-5. doi: 10.1111/j.1365-2044.1998.53s113.x.
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Propofol anaesthesia via target controlled infusion or manually controlled infusion: effects on the bispectral index as a measure of anaesthetic depth.通过靶控输注或手动控制输注进行丙泊酚麻醉:对作为麻醉深度指标的脑电双频指数的影响。
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[Target-controlled intravenous anesthesia].[靶控静脉麻醉]
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Individual titration of propofol plasma target improves anaesthetic stability in patients undergoing major abdominal surgery: a comparison with manually controlled infusion.丙泊酚血浆靶控个体化滴定可提高腹部大手术患者的麻醉稳定性:与手动控制输注的比较
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Recent advances in intravenous anaesthesia.静脉麻醉的最新进展
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[Feedback control of depth of anesthesia during propofol administration. Bispectral index as the controlled variable].

本文引用的文献

1
Effect site concentration during propofol TCI sedation: a comparison of sedation score with two pharmacokinetic models.丙泊酚靶控输注镇静期间效应室浓度:两种药代动力学模型的镇静评分比较
Anaesthesia. 2007 Jul;62(7):661-6. doi: 10.1111/j.1365-2044.2007.05059.x.
2
Predictive performance of 'Servin's formula' during BIS-guided propofol-remifentanil target-controlled infusion in morbidly obese patients.“塞尔文公式”在病态肥胖患者双频谱指数(BIS)引导下丙泊酚-瑞芬太尼靶控输注中的预测性能。
Br J Anaesth. 2007 Jan;98(1):66-75. doi: 10.1093/bja/ael321. Epub 2006 Nov 27.
3
Effect site concentrations of remifentanil maintaining cardiovascular homeostasis in response to surgical stimuli during bispectral index guided propofol anestesia in seriously obese patients.
[丙泊酚给药期间麻醉深度的反馈控制。以脑电双频指数作为控制变量]
Anaesthesist. 2010 Jul;59(7):621-7. doi: 10.1007/s00101-010-1731-9.
4
[EEG-adjusted target-controlled infusion : Propofol target concentration with different doses of remifentanil].[脑电图调整的靶控输注:不同剂量瑞芬太尼下的丙泊酚靶浓度]
Anaesthesist. 2010 Feb;59(2):126-34. doi: 10.1007/s00101-009-1666-1.
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[Target-controlled infusion. Clinical relevance and special features when using pharmacokinetic models].[靶控输注。使用药代动力学模型时的临床相关性及特点]
Anaesthesist. 2009 Jul;58(7):708-15. doi: 10.1007/s00101-009-1575-3.
在严重肥胖患者的脑电双频指数引导丙泊酚麻醉期间,瑞芬太尼维持心血管稳态以应对手术刺激的效应室浓度。
Minerva Anestesiol. 2006 Nov;72(11):915-24.
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The contribution of remifentanil to middle latency auditory evoked potentials during induction of propofol anesthesia.瑞芬太尼在丙泊酚麻醉诱导期间对中潜伏期听觉诱发电位的影响。
Anesth Analg. 2006 Oct;103(4):902-7. doi: 10.1213/01.ane.0000237282.76394.6b.
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The performance of a target-controlled infusion of propofol in combination with remifentanil: a clinical investigation with two propofol formulations.丙泊酚与瑞芬太尼靶控输注的性能:两种丙泊酚制剂的临床研究
Anesth Analg. 2006 Feb;102(2):430-7. doi: 10.1213/01.ane.0000189821.81675.b4.
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The effect-site concentration of remifentanil blunting cardiovascular responses to tracheal intubation and skin incision during bispectral index-guided propofol anesthesia.在双谱指数引导的丙泊酚麻醉期间,瑞芬太尼效应室浓度对气管插管和皮肤切开引起的心血管反应的抑制作用。
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Performance evaluation of two published closed-loop control systems using bispectral index monitoring: a simulation study.使用脑电双频指数监测对两种已发表的闭环控制系统进行性能评估:一项模拟研究。
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